TJie aim of the study was to examine the influence of different periods of sitting, before turning the patient to the supine position on the spread of analgesia and on hemodynamic changes induced by subarachnoid in jection of hyperbaric bupivacaine solution as a trial to verify the principle of sitting after subarachnoid injection ofhyperbaric anesthetic solutions. The study comprised 60 patients aged 18-56 years assigned to receive spinal anesthesia using 6.5% bupivacaine in 8% glucose. Patients were randomly allocated in 4 equal groups according to the duration of sitting (2, 5, 10 & 20 mini after the spinal injection. Analgesia, defined as inabili ty to detect a sharp pinprick, was assessed every 5-minfor 30 min after the injection and at 45 and 60 min. The level of analgesia was defined prior to (baseline level) and immediately after turning the patient to su pine position, and 20 minutes after anesthetic injection, and at achieve ment of the highest level. The mean increase of the level of analgesia was defined in relation to the baseline level of analgesia. Motor block was also evaluated. Systolic arterial pressure (SAP) and heart rate (HR) were moni tored non-invasively.All groups showed increased level of analgesia after turning the patients from sitting to the supine position with the 20-min pe riod of sitting induced the least degree of increase of the level of analge sia compared to the other groups. Time lapsed till achievement of highest level of analgesia was significantly prolonged in.group IV, however, the extent of increase of analgesia level at time of achievement of the highest level showed a nonsignificant difference between all groups. Conse quently, the increase in the upper analgesia levels beyond 20 min was significantly (P<0.05) larger in group N |
