The Effect of Local Anaesthesia at Different Temperatures on Spinal Anaesthesia

Abstract

Background: Aim: The aim of this study was to evaluate the effects of the use of 0.5% levobupivacaine at room temperature and at 4ºC on the characteristics of subarachnoid block. Methods: Approval for this prospective, randomised, single-centre and double-blind study was granted by the Local Ethics Committee. Informed consent was obtained from all the patients. The study comprised 60 patients, for whom orthopaedic lower extremity surgery. In the operating room, after standart monitorization spinal anesthesia was made with a 27-gauge Quincke spinal needle from the L3-L4 interspinous gap. The patients were randomly separated into 2 groups. Patients in Group I were injected 3ml 0.5% levobupivacaine solution which had been kept at room temperature (mean 23ºC) and the patients in Group II with 3ml 0.5% levobupivacaine solution which had been kept at 4ºC for at least 24 hours. The patients were evaluated in respect of sensorial and motor block parameters, haemodynamic profiles and the incidence of side-effects. Results: The time to reach T12 sensory block was determined as statistically significantly shorter in Group I compared to Group II (p<0.05). The maximum sensory block levels in Group II were found to be in the lower dermatomes to a significant degree compared to Group I (p<0.05). No statistically significant difference was determined between the groups in respect of another parameters. Conclusion: It was determined that the application of spinal anesthesia with 0.5 % levobupivacaine at 4ºC causes lower levels of sensory block, with a slower onset and which are of shorter duration.