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Biomedical subjects

A Benkhadra

Publications and source records attributed to A Benkhadra.

7 recordsLinked to original sources
PubMed1991

[Metaraminol does not prolong the duration of spinal anesthesia using glucose-free bupivacaine in the upper dermatomes].

The effects of metaraminol on the duration of plain bupivacaine spinal anaesthesia were investigated in a double-blind study of 80 elderly patients. Each patient received a basic solution of 0.5% plain bupivacaine to which was added either physiological saline, or 1 mg, 2 mg or 3 mg metaraminol. There were no significant differences between the four groups in the mean time from injection to recovery from analgesia in the two and four uppermost segments. However the addition of metaraminol increased the mean durations of analgesia at the L2 level and of the motor block. It is concluded that, in an attempt to prolong plain bupivacaine spinal anaesthesia in the uppermost segments, addition of metaraminol does not appear to be justified.

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Failure of phenylephrine to prolong isobaric bupivacaine spinal anesthesia in elderly patients.

BACKGROUND AND OBJECTIVES: The effects of phenylephrine on the duration of spinal anesthesia produced by plain bupivacaine were investigated in a double-blind study of 100 elderly patients. METHODS: Each patient received a basic solution of 3 ml 0.5% plain bupivacaine to which was added either 1 ml physiologic saline, 0.2 ml (1 mg) 0.5% phenylephrine plus 0.8 ml normal saline, 0.4 ml phenylephrine plus 0.6 ml normal saline, 0.6 ml phenylephrine plus 0.4 ml normal saline, or 0.8 ml phenylephrine plus 0.2 ml normal saline. RESULTS: The duration of sensory block (measured by two- and four-segment regression times and times to regression to T12 and L2 dermatomes) was not statistically prolonged by addition of phenylephrine. CONCLUSION: It is concluded that, in an attempt to prolong plain bupivacaine spinal anesthesia, the addition of phenylephrine does not appear to be advantageous for routine clinical practice.

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A comparison of cardiovascular responses of normotensive and hypertensive elderly patients following bupivacaine spinal anesthesia.

The hypotensive effects of spinal anesthesia were investigated in 60 patients aged 75 years or older and divided into two groups: 30 normotensive patients (group 1) and 30 treated hypertensive patients (group 2). In both groups, spinal anesthesia was performed in lateral decubitus position with 3 ml 0.5% isobaric bupivacaine. Hemodynamic measurements were performed before the establishment of spinal blockade and repeated during the 60 minutes following intrathecal injection. Median cephalad level (T10) and ranges of sensory blockade were similar in the two groups. Changes from baseline to lowest blood pressures showed significant decreases in group 2 compared with group 1:10.7% in SPB, 11.2% in MBP, and 14.8% in DBP. Hypotension was observed in three group 1 patients and ten group 2 patients. Five patients in group 2 (but none in group 1) had a SBP decrease of 40% from baseline or more. The decreases in MBP and DBP were persistent after 60 minutes. These results suggest that pre-existing hypertension can be recognized as an important factor to explain blood pressures changes during isobaric bupivacaine spinal anesthesia in elderly patients.

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