J Korean Pain Soc.  1988 Jun;1(1):20-27.

Clinical Study of Continuous Cervical Epidural Anesthesia with Bupivacaine

• Gil SH
• Hwang KH
• Park W

Abstract

Continuous cervical epidural anesthesia with two different concentrations of bupivacaine had been performed in 43 cases for surgery of upper extremity and cervical spine. After the initial dose of 0.33% bupivacaine 15ml to Group I (n = 22) and 0.5% bupivacaine 15ml to Group II (n = 21) was injected respectively, we observed the circulatory and pulmonary functions to be changed, and evaluated the duration of those analgesic action. The number of spinal segment to be affected and the complications were checked. Statistical significance of changes after the initial dose in both groups was determined by student's t-test. All values are impressed as mean+/-1S.D.. The results were as follows: l) Circulatory functions; Systolic B.P. and pulse rate were decreased by 10-15 torr and 5-6 beats per minute respectively between 10-30 minutes following the initial dose, which were statistically significant in both groups. 2) Pulmonary functions; The diminution of minute volume showed to 20% and a rise of PaCO2 level to 5-6 torr respectively between 30-60 minutes following the initial dose, which were statistically significant in both groups. There were no significant changes in self respiration and respiratory rate in both groups. 3) The duration of analgesic action was 72.3+/-25. 7 (min) in Group I and 83.5+/-28. 5 (min) in Group II which was not statistically significant between two groups, and the number of affected spinal segment at one hour following the Anesthusia was 8.7+/-2.0 in Group I and 10.5+/-2.4 in Group II which was statistically significant between two groups. 4) Complications; a. Hypotension (below 80torr in systolic pressure) was appeared in 5% of all patients. b. Bradycardia (below 60 beats per minutes) was appeared in 25% of all patients. c. Inadvertent dural puncture was developed in only one patient. In conclusion, the 0.33% bupivacaine as weIl as 0.5% bupivacaine were enough for those analgesic effect in the above mentioned surgery even though the duration of analgesic action was about 10 minutes shorter in Group I than that of Group II. The cardiopulmonary function was clinically rather stable in Group I than that of Group II. Therefore we thought 0.33% bupivacaine was satisfactory for the clinical practicality in the cervical epidural anesthesia.

MeSH Terms

Anesthesia, Epidural*
Bradycardia
Bupivacaine*
Heart Rate
Humans
Hypotension
Punctures
Respiration
Respiratory Rate
Spine
Upper Extremity
Bupivacaine