संज्ञानश्वासन और निदान शोध जर्नल
खुला एक्सेस

अमूर्त

Randomized Comparative Evaluation of the Block Characteristics of Epidural Injection of Different Lidocaine-Bupivacaine Mixtures for Lower Limb Surgeries

Uma Mong Kalu, Chimaobi Tim Nnaji*, Charles Imarengiaye

Background: Combination of Local anaesthetics for epidural anaesthesia will improve block characteristics and reduce toxicity. Previous studies have shown lidocaine to shorten onset time while bupivacaine prolongs duration of anaesthesia.

Objective: The aim of this study was to comparatively evaluate the block characteristics of epidural injection of different lidocaine-bupivacaine mixtures for lower limb surgeries.

Methods: Sixty-three patients receive either 15 ml of 0.5% Isobaric-bupivacaine and 5 ml of 2% Lidocaine (group A), or 15 ml of 0.5% Isobaric-bupivacaine, 2.5 ml of 2% Lidocaine and 2.5 ml normal saline (group B) or 15 ml of 0.5% Isobaric-bupivacaine and 5 ml of normal saline (group C). The primary outcome was the onset time of sensory block. The secondary outcomes were the onset of motor blockade, degree of sensory block level and motor blockade, duration of sensory block and motor block and the incidence of side effects. Data collected were analysed using Statistical Package for Scientific Solutions (SPSS) version 20 and presented as tables, graphs and charts. A p-value of <0.05 was considered as statistically significant.

Results: The onset time of sensory and motor block were significantly faster in Group A (6.33 ± 1.35 min and 16.48 ± 1.66 min), compared with Group B (8.05 ± 1.77 min and 19.52 ± 1.89 min) and Group C (10.55 ± 1.91 min and 25.52 ± 1.72 min), p<0.001 and p<0.001 respectively. The maximum height of sensory block achieved was T3 in Group A, T3 in Group B and T4 in Group C, p<0.001. The duration of sensory block was statistically longer in Group A (279.81 ± 9.37 min) compared with Groups B (267.95 ± 5.92 min) and C (265.45 ± 4.91 min), p<0.001. The duration of motor block was 140.67 ± 2.24 min in Group A, 139.81 ± 2.38 min in Group B and 139.58 ± 1.54 min in Group C, p=0.21.

Conclusion: This study shows that when different volumes of the same concentration of lidocaine is added to specific amount of isobaric bupivacaine epidural injection, it provided faster onset and prolonged duration of sensory block, with stable haemodynamic, and no complications compared to when bupivacaine alone is used.