This study will be conducted to evaluate the effect of different temperature on the spinal anesthesia characteristics and incidence of complications
Regional anesthesia techniques are also superior to systemic opioids agents with regard the analgesic profile and adverse effects .Spinal anesthesia is the most commonly used technique due to its unmatchable reliability,simplicity and cost-effectiveness. It provides a fast and effective onset of sensory and motor block, excellent muscle relaxation and prolonged postoperative analgesia . Bupivacaine is commonly used local anesthetics because of its long duration of action and combined motor and sensory blockade. However, it has many drawbacks .It has a high propensity to cause hypotension and bradycardia. There is also cardiac toxicity.Levobupivacaine is an attractive alternative to bupivacaine because of the lower affinity for cardiac sodium channels and reducing the risk of cardiac toxicity.Moreover ,the isobaric levobupivacaine had more stability in cerebrospinal fluid and thus lead to more predictable drug spread, decreasing the incidence of hypotension and bradycardia. But its main disadvantage is the delayed onset . A number of strategies have been used to hasten the onset of local anesthesia .The addition of fentanyl mixtures of local anesthetics and alkalization of the local anesthetics all shorten the onset time of sensory block. Recently the warming of the anesthetic agents (namely, lidocaine and bupivacaine) to 37° C hastens the sensory block in various surgical settings . Up till now there is no study suggestive of any appropriate degree of temperature as adjuvant .Hence the present study will be conducted to evaluate the effect of different temperature on spinal anesthesia characteristics and the incidence its complication
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
120
Drug: levobupivacaine at room temperature ( 23˚C) and second group levobupivacaine warmed to the (30˚C) while the third group levobupivacaine warmed to the body temperature (37˚C)
Adham Elgeidi
Al Mansurah, Dakahliah, Egypt
Time to onset of sensory block
Defined as the time interval between the end of spinal anesthesia injection and the loss of sensation to pin prick (sensory score=1)
Time frame: For 10 minutes following the spinal anesthesia
Time to the onset of motor block
Defined as the time interval between the end of spinal anesthesia and (motor score=1) within both lower limbs
Time frame: For 10 minutes following the injection of spinal anesthesia
Duration of sensory block
Defined as the interval between the end of spinal anesthesia and complete end of sensory block (sensory score=2)
Time frame: For 24 hours after the spinal anesthesia
Duration of motor block
Defined as the interval between the end of spinal anesthesia and complete recovery of normal motor function (score=0)
Time frame: For 24 hours after the spinal anesthesia
Post spinal shivering
Post spinal shivering will be graded using a scale ( score 0=no shivering ,score 1= no visible muscle activity ,but one or more of piloerection, score 2=muscular activity in only one muscle group,score 3=moderate muscular activity in more than one muscle group but not generalized shaking ,score 4=violent muscular activity that involves entire body )
Time frame: for 24 hours after spinal anesthesia
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