Yunus Baydilek1, Bülent Serhan Yurtlu2, Volkan Hanci3, Hilal Ayoğlu4, Rahşan Dilek Okyay4, Gulay Erdoğan Kayhan5, Hüsnü Tokgöz6, Görkem Mungan7, Işıl Ozkoçak4. 1. Clinic of Anesthesiology Sani Konukoğlu Hospital, Gaziantep, Turkey. 2. Department of Anesthesiology and Reanimation, Bulent Ecevit University, Zonguldak, Turkey. Electronic address: syurtlu68@gmail.com. 3. Department of Anesthesiology and Reanimation, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. 4. Department of Anesthesiology and Reanimation, Bulent Ecevit University, Zonguldak, Turkey. 5. Department of Anesthesiology and Reanimation, Inonü University, Zonguldak, Turkey. 6. Department of Urology, Bulent Ecevit University, Zonguldak, Turkey. 7. Department of Biochemistry, Bulent Ecevit University, Zonguldak, Turkey.
Abstract
BACKGROUND: The aim of the study is to compare the efficacy of levobupivacaine induced continuous spinal anesthesia (CSA) versus single dose spinal anesthesia (SDSA) in patients who are planned to undergo transurethral prostate resection. METHODS: Sixty years or older, ASA I-II or III, 50 patients were included in the study. 12.5mg 0.5% levobupivacaine were administered intrathecally in SDSA group. In CSA group, initially 2mL of 0.25% levobupivacaine were administered through spinal catheter. In order to achieve sensory block level at T10 dermatome, additional 1mL of 0.25% levobupivacaine were administered through the catheter in every 10min. Hemodynamic parameters and block characteristics were recorded. Preoperative and postoperative blood samples of the patients were drawn to determine plasma cortisone and plasma epinephrine levels. RESULTS: CSA technique provided better hemodynamic stability compared to SDSA technique particularly 90min after intrathecal administration. The rise in sensory block level was rapid and the time to reach surgical anesthesia was shorter in SDSA group. Motor block developed faster in SDSA group. In CSA group, similar anesthesia level was achieved by using lower levobupivacaine dose and which was related to faster recovery. Although, both techniques were effective in preventing surgical stress respond, postoperative cortisone levels were suppressed more in SDSA group. CONCLUSION: CSA technique with 0.25% levobupivacaine can be used as a regional anesthesia method for elderly patients planned to have TUR-P operation.
BACKGROUND: The aim of the study is to compare the efficacy of levobupivacaine induced continuous spinal anesthesia (CSA) versus single dose spinal anesthesia (SDSA) in patients who are planned to undergo transurethral prostate resection. METHODS: Sixty years or older, ASA I-II or III, 50 patients were included in the study. 12.5mg 0.5% levobupivacaine were administered intrathecally in SDSA group. In CSA group, initially 2mL of 0.25% levobupivacaine were administered through spinal catheter. In order to achieve sensory block level at T10 dermatome, additional 1mL of 0.25% levobupivacaine were administered through the catheter in every 10min. Hemodynamic parameters and block characteristics were recorded. Preoperative and postoperative blood samples of the patients were drawn to determine plasma cortisone and plasma epinephrine levels. RESULTS:CSA technique provided better hemodynamic stability compared to SDSA technique particularly 90min after intrathecal administration. The rise in sensory block level was rapid and the time to reach surgical anesthesia was shorter in SDSA group. Motor block developed faster in SDSA group. In CSA group, similar anesthesia level was achieved by using lower levobupivacaine dose and which was related to faster recovery. Although, both techniques were effective in preventing surgical stress respond, postoperative cortisone levels were suppressed more in SDSA group. CONCLUSION:CSA technique with 0.25% levobupivacaine can be used as a regional anesthesia method for elderly patients planned to have TUR-P operation.