Eur Spine J DOI 10.1007/s00586-014-3174-5
LETTER TO THE EDITOR
A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery Monica del-Rio-Vellosillo • Jose Javier Garcia-Medina • Maria Dolores Pinazo-Duran • Antonio Abengochea-Cotania
Received: 25 November 2013 / Revised: 8 January 2014 / Accepted: 8 January 2014 Ó Springer-Verlag Berlin Heidelberg 2014
Dear Sirs, With great interest, we have read the article by Sahin et al. [1] that deals with levobupivacaine and bupivacaine in spinal anesthesia. They administered 3 ml of 0.5 % isobaric bupivacaine or levobupivacaine, and concluded that the onsets of sensory and motor blockades were similar with both local anesthetics. Otherwise, they found that the maximum level of sensory blockade was higher in levobupivacaine, and that the recovery times of sensory and motor blockades were shorter in the levobupivacaine group. We also recently conducted a study with both these local anesthetics in spinal anesthesia for knee arthroscopy [2]. We administered 2.5 ml of 0.5 % isobaric bupivacaine or levobupivacaine, and the sensory and motor blockades
M. del-Rio-Vellosillo (&) Department of Anesthesia, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n 30120 El Palmar, Murcia, Spain e-mail: [email protected] J. J. Garcia-Medina Department of Ophthalmology and Optometry, University School of Medicine, University of Murcia, Av Intendente Jorge Palacios, 1, 30003 Murcia, Spain e-mail: [email protected]
onsets were significantly faster in the bupivacaine group. The maximum level of sensory blockade was significantly higher in the bupivacaine group and no significant difference was noted in the recovery times of the sensory and motor blockades. The methods used by Sahin et al. and our group were similar. Nevertheless, some questions are raised that may help to understand the differences in the results. We would like to ask them if they maintained the fluid therapy constant rate after considering the patient’s weight. The pre-operative and peri-operative fluid therapy was constant in our study when we considered the patient’s weight. We think it is important because it could affect the sensitive blockade and hemodynamic parameters [3, 4]. Furthermore, it would be interesting to know if Sahin et al. used a constant speed with spinal injection and if they used barbotage or aspiration. In our study, we used constant speed without barbotage. We think it is important because it could affect the sensory and motor blockade onset and the extension of sensory blockade [5]. In addition, it would be of great interest to analyze the time with no analgesia requirement since spinal anesthesia. In our study, these data were analyzed where the levobupivacaine group required analgesia earlier. The authors can certainly enlighten readers in these aspects. None.
M. D. Pinazo-Duran Department of Ophthalmology, University School of Medicine University of Valencia, Avda. Blasco Iba´n˜ez 15-17, 46010 Valencia, Spain e-mail: [email protected]
Conflict of interest
A. Abengochea-Cotania Department of Anesthesia, University Hospital La Fe, Bulevar del Sur, 46026 Valencia, Spain e-mail: [email protected]
1. Sahin AS, Tu¨rker G, Bekar A, Bilgin H, Korfalı G (2013) A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery. Eur Spine J 9. doi:10.1007/s00586-013-3082-0
References
123
Eur Spine J 2. del-Rio-Vellosillo M, Garcia-Medina JJ, Pinazo-Duran MD, Abengochea-Cotaina A, Barbera-Alacreu M (2013) Spinal anesthesia for knee arthroscopy using isobaric bupivacaine and levobupivacaine. Anesthestic and neuro-opthalmological assessment. Biomed Res Int In press. Available on: http://www.hindawi. com/journals/bmri/aip/349034/ 3. Shin BS, Ko JS, Gwak MS, Yang M, Kim CS, Hahm TS, Lee SM, Cho HS, Kim ST, Kim JH, Kim GS (2008) The effects of prehydration on the properties of cerebrospinal fluid and the spread of isobaric spinal anesthetic drug. Anesth Analg 106:1002–1007. doi:10.1213/ane.0b013e318161520c
123
4. Mojica JL, Mele´ndez HJ, Bautista LE (2002) The timing of intravenous crystalloid administration and incidence of cardiovascular side effects during spinal anesthesia: the results from a randomized controlled trial. Anesth Analg 94:432–437. doi:10. 1213/00000539-200202000-00039 5. Hanazaki M, Hashimoto M, Nogami S, Kusudo K, Aono H, Takeda A (1997) Effect of injection speed on sensory blockade in spinal anesthesia with 0.5 % hyperbaric tetracaine. Masui 46:777–782
LETTER TO THE EDITOR
A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery Monica del-Rio-Vellosillo • Jose Javier Garcia-Medina • Maria Dolores Pinazo-Duran • Antonio Abengochea-Cotania
Received: 25 November 2013 / Revised: 8 January 2014 / Accepted: 8 January 2014 Ó Springer-Verlag Berlin Heidelberg 2014
Dear Sirs, With great interest, we have read the article by Sahin et al. [1] that deals with levobupivacaine and bupivacaine in spinal anesthesia. They administered 3 ml of 0.5 % isobaric bupivacaine or levobupivacaine, and concluded that the onsets of sensory and motor blockades were similar with both local anesthetics. Otherwise, they found that the maximum level of sensory blockade was higher in levobupivacaine, and that the recovery times of sensory and motor blockades were shorter in the levobupivacaine group. We also recently conducted a study with both these local anesthetics in spinal anesthesia for knee arthroscopy [2]. We administered 2.5 ml of 0.5 % isobaric bupivacaine or levobupivacaine, and the sensory and motor blockades
M. del-Rio-Vellosillo (&) Department of Anesthesia, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n 30120 El Palmar, Murcia, Spain e-mail: [email protected] J. J. Garcia-Medina Department of Ophthalmology and Optometry, University School of Medicine, University of Murcia, Av Intendente Jorge Palacios, 1, 30003 Murcia, Spain e-mail: [email protected]
onsets were significantly faster in the bupivacaine group. The maximum level of sensory blockade was significantly higher in the bupivacaine group and no significant difference was noted in the recovery times of the sensory and motor blockades. The methods used by Sahin et al. and our group were similar. Nevertheless, some questions are raised that may help to understand the differences in the results. We would like to ask them if they maintained the fluid therapy constant rate after considering the patient’s weight. The pre-operative and peri-operative fluid therapy was constant in our study when we considered the patient’s weight. We think it is important because it could affect the sensitive blockade and hemodynamic parameters [3, 4]. Furthermore, it would be interesting to know if Sahin et al. used a constant speed with spinal injection and if they used barbotage or aspiration. In our study, we used constant speed without barbotage. We think it is important because it could affect the sensory and motor blockade onset and the extension of sensory blockade [5]. In addition, it would be of great interest to analyze the time with no analgesia requirement since spinal anesthesia. In our study, these data were analyzed where the levobupivacaine group required analgesia earlier. The authors can certainly enlighten readers in these aspects. None.
M. D. Pinazo-Duran Department of Ophthalmology, University School of Medicine University of Valencia, Avda. Blasco Iba´n˜ez 15-17, 46010 Valencia, Spain e-mail: [email protected]
Conflict of interest
A. Abengochea-Cotania Department of Anesthesia, University Hospital La Fe, Bulevar del Sur, 46026 Valencia, Spain e-mail: [email protected]
1. Sahin AS, Tu¨rker G, Bekar A, Bilgin H, Korfalı G (2013) A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery. Eur Spine J 9. doi:10.1007/s00586-013-3082-0
References
123
Eur Spine J 2. del-Rio-Vellosillo M, Garcia-Medina JJ, Pinazo-Duran MD, Abengochea-Cotaina A, Barbera-Alacreu M (2013) Spinal anesthesia for knee arthroscopy using isobaric bupivacaine and levobupivacaine. Anesthestic and neuro-opthalmological assessment. Biomed Res Int In press. Available on: http://www.hindawi. com/journals/bmri/aip/349034/ 3. Shin BS, Ko JS, Gwak MS, Yang M, Kim CS, Hahm TS, Lee SM, Cho HS, Kim ST, Kim JH, Kim GS (2008) The effects of prehydration on the properties of cerebrospinal fluid and the spread of isobaric spinal anesthetic drug. Anesth Analg 106:1002–1007. doi:10.1213/ane.0b013e318161520c
123
4. Mojica JL, Mele´ndez HJ, Bautista LE (2002) The timing of intravenous crystalloid administration and incidence of cardiovascular side effects during spinal anesthesia: the results from a randomized controlled trial. Anesth Analg 94:432–437. doi:10. 1213/00000539-200202000-00039 5. Hanazaki M, Hashimoto M, Nogami S, Kusudo K, Aono H, Takeda A (1997) Effect of injection speed on sensory blockade in spinal anesthesia with 0.5 % hyperbaric tetracaine. Masui 46:777–782
