-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 15㎖ to Group Ⅰ (n=22) and 0.5%
bupivacaine 15㎖ 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 impresed as mean ±1S.D..
The results were as follows:
1) Circulatory functions; Systolic B.P. and Pulse rate were decreased by 10∼15torr
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
o: Pac02 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±2i.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 ore 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 well 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.
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