Circadian Effects on Neural Blockade of Intrathecal Hyperbaric Bupivacaine.
10.3344/kjp.2010.23.3.186
- Author:
Cheol LEE
1
;
Deok Hwa CHOI
;
Soo Uk CHAE
Author Information
1. Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Iksan, Korea. aphonic@wonkwang.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
circadian effect;
hour of administration;
local anesthetics
- MeSH:
Absorption;
Anesthesia, Local;
Anesthesia, Spinal;
Anesthetics, Local;
Bradycardia;
Bupivacaine;
Humans;
Hypotension;
Injections, Spinal;
Nausea;
Orthopedics;
Protein Binding;
Sensation;
Shivering
- From:The Korean Journal of Pain
2010;23(3):186-189
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Circadian variations in the absorption, distribution, protein binding, elimination and metabolism of drugs account for many of the administration-time-dependent differences in their pharmacokinetics. The aim of this study is to determine whether the time of intrathecal injection influences spinal anesthesia. METHODS: Ninety patients scheduled for orthopedic surgery were randomly assigned to three groups. Each group received spinal anesthesia with 0.5% bupivacaine 10 mg at different times; group AM (8 am to 12:00), group Noon (12:00 to 4:00 pm) and group PM (4:00 pm to 8:00 pm). Sensory and motor blockade were assessed by pinprick and a four-point modified Bromage scale. Time to first postoperative analgesic requirement and side effects such as hypotension, bradycardia, nausea, and shivering were recorded. RESULTS: No significant differences were found among the three groups in peak sensory blockade, duration of motor block to Bromage 1 or side effects, but time to first postoperative analgesic requirement (P = 0.008), and recovery time of S1 sensation to pinprick were significantly prolonged in group Noon compared with the other groups (P = 0.03). CONCLUSIONS: The tine of administration of spinal local anesthetics influences the duration of local anesthesia.
