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Double-blind Evaluation of Intrathecal Hyperbaric and Glucose-free Bupivacaine on Analgesia and Cardiovascular Function
  1. Dennis Bigler, MD*,
  2. Ib W. Møller, MD*,
  3. Nils-Christian Hjortsø, MD,
  4. Torben Mogensen, MD,
  5. Håkan H. Edström, PhD and
  6. Henrik Kehlet, MD§
  1. *From the Department of Anesthesiology, Bispebjerg Hospital, Copenhagen, Denmark;
  2. Department of Anesthesiology, Hvidovre University Hospital, Denmark;
  3. Medical Department, Astra Läkemedel AB, Södertälje, Sweden;
  4. §the Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark


The effect of baricity of 0.5% bupivacaine on analgesia and cardiovascular function when used for spinal anaesthesia was evaluated in 40 healthy male patients. Three ml of either hyperbaric (8% glucose) or glucose-free solution was used, and the injections were made in the lateral supine position. Cephalad spread of sensory (pinprick) and temperature (ice water) analgesia, mean arterial pressure, and heart rate were assessed. Spread of sensory and temperature analgesia was statistically significantly higher with the hyperbaric solution (Th5±1) compared with the glucose-free solution (Th8±1). Average time for maximum spread of analgesia was 21 minutes with both solutions. Mean arterial pressure decreased by approximately 10% in both groups and without statistically significant difference. Changes in heart rate were small and similar in both groups. No statistically significant differences in rate pressure product were seen. One patient in the hyperbaric group received ephedrine because of bradycardia. No other adverse reactions were seen.

  • Spinal anesthesia
  • bupivacaine
  • analgesia
  • cardiovascular changes

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