고비중 척추마취시 필첨바늘의 출구방향이 신경차단범위와 차단기간에 미치는 영향 = Effect of Direction of Pencil-Point Tip Needle Sideport on the Extent and Duration of Hyperbaric Spinal Anesthesia

다국어 초록 (Multilingual Abstract)

Background: The endogenous and exogenous factors influence the distribution of local anesthetic solutions within the subarachnoid space. This study was designed to examine the influence of direction of pencil-point tip needle sideport using a 25 gauge Whitacre needle(Vygon, France).
Methods: Thirty adult male patients undergoing orthopedic, urologic or anal surgery were divided randomly into two groups according to the direction of the needle sideport(cephalad or caudad). Intrathecal anesthesia were performed with 10mg of 0.5% hyperbaric bupivacaine. The technique was typically performed using a midline approach at L4-5 interspace in the lateral decubitus position and the patients were turned to supine position immediately after the block. After the injection, we registered the segmental spread of analgesia(pin-prick). Duration of block(two segment regression time) and degree of motor block(Bromage scale) were measured.
Results: There were no significant differences in onset time to maximal level of sensory and motor block, two segment regression time between groups. Mean maximal sensory level was T6.1± 1.6 for the cephalad group vs T7.0±1.8 for the caudad group, but no statistical significance was found.
Conclusions: This study suggests that needle sideport direction of Whitacre needles does not significantly influence extent and duration of hyperbaric spinal anesthesia.