Continuous spinal anesthesia: dose requirements and characteristics of the block

Reg Anesth. 1993 Jan-Feb;18(1):52-4.

Abstract

Background and objectives: A fine-bore 28G CoSpan spinal catheter was used to provide continuous spinal anesthesia for major upper and lower abdominal, peripheral vascular, and orthopedic surgery in 90 patients, aged 31-91 years.

Methods: Initial doses (0.5-2.0 mL) of hyperbaric bupivacaine 0.5% were given and followed, if needed, by additional doses of 0.5-1.0 mL to achieve a satisfactory blockade for the proposed type of surgery. The incidence of hypotension, ambulatory postdural puncture headache, and technical problems encountered with insertion of the spinal catheters were recorded.

Results: The technique of continuous spinal anesthesia was successful and easy to learn. Satisfactory sensory and motor blockade was achieved within 12-18 minutes, and surprisingly small amounts were needed in those patients undergoing limb surgery.

Conclusions: Mild postdural puncture headache occurred in four patients, but none of the patients required blood patch. One catheter broke during removal; since then, it has been our policy to remove a catheter with the patient in a flexed position.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Abdomen / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Spinal / adverse effects
  • Anesthesia, Spinal / instrumentation
  • Anesthesia, Spinal / methods*
  • Bupivacaine
  • Catheterization
  • Dose-Response Relationship, Drug
  • Headache / chemically induced
  • Headache / etiology
  • Humans
  • Hypotension / chemically induced
  • Hypotension / etiology
  • Incidence
  • Middle Aged
  • Nerve Block

Substances

  • Bupivacaine