The effect of the intravenous phenylephrine on the level of spinal anesthesia.
10.4097/kjae.2011.61.5.372
- Author:
Young Hoon PARK
1
;
Taeha RYU
;
Seong Wook HONG
;
Kyung Hwa KWAK
;
Si Oh KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Kyungpook National University Hospital, Daegu, Korea. anesryu@hmail.knu.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Cerebrospinal fluid;
Dermatomal spread;
Phenylephrine;
Sensory block;
Spinal anesthesia
- MeSH:
Anesthesia, Spinal;
Autonomic Nerve Block;
Blood Pressure;
Bradycardia;
Cold Temperature;
Female;
Heart;
Hemodynamics;
Humans;
Hypotension;
Incidence;
Injections, Spinal;
Phenylephrine;
Pregnant Women;
Sensation
- From:Korean Journal of Anesthesiology
2011;61(5):372-376
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Spinal anesthesia causes hypotension and bradycardia due to sympathetic nerve block and it is difficult to predict the level of sensory block and the duration of blockade. Recent studies have reported that intravenous phenylephrine can reduce the rostral spread of spinal anesthesia in pregnant women. We think a phenylephrine infusion will be useful for maintaining the baseline blood pressure by reducing the rostral spread of spinal anesthesia during the elective surgery of non-obstetric patients. METHODS: Sixty patients who were undergoing urologic surgery were randomized into two groups: Group C (the control group without phenylephrine) and Group P (with the addition of phenylephrine). After a bolus infusion of 50 microg phenylephrine following the spinal injection, phenylephrine was continuously infused at the rate of 200 microg/hr. We compared the dermatomal spreads of spinal anesthesia, the hemodynamic parameters (blood pressure, heart rate) and the incidences of hypotension between the two groups. RESULTS: At 20 minutes, the level of the upper dermatome blocked against cold sensation was a median of T8 (interquartile range: T8-T10) for the phenylephrine group, as compared with T4 (interquartile range: T4-T6) for the control group (P < 0.001). CONCLUSIONS: Intravenous phenylephrine can decrease the rostral spread of spinal anesthesia during urologic surgery.
