The Bupivacaine Dose Sparing Effect of Intrathecal Epinephrine for Spinal Anesthesia in Total Knee Replacement Arthroplasty
Overview
- Phase
- Not Applicable
- Intervention
- Placebo
- Conditions
- Spinal Anesthesia
- Sponsor
- Seoul Medical Center
- Enrollment
- 75
- Locations
- 1
- Primary Endpoint
- the sensory level of spinal anesthesia, the quality of intraoperative analgesia
- Status
- Completed
- Last Updated
- 14 years ago
Overview
Brief Summary
Intrathecal epinephrine has been known to increase the duration of spinal anesthesia, or increase the quality of anesthesia. However, there is still a controversy, and the mechanism of epinephrine is recently suggested as a modulator of pain information in the spinal cord. Therefore, the investigators try to investigate the dose sparing effect of intrathecal epinephrine for spinal anesthesia with bupivacaine.
Detailed Description
For patient undergoing total knee replacement arthroplasty, patients injected intrathecally with bupivacaine 8 mg were compared with those with bupivacaine 8 mg with 25 mcg of epinephrine, bupivacaine 8 mg with 50 mcg of epinephrine, and those with bupivacaine 8 mg with 100 mcg of epinephrine. The investigators compared the characteristics of spinal anesthesia including the quality and complication of spinal anesthesia. The researchers investigated whether intrathecal dose of epinephrine can reduce bupivacaine requirement and this effect is dependent on the dose of epinephrine.
Investigators
Eligibility Criteria
Inclusion Criteria
- •patient undergoing total knee replacement arthroplasty
Exclusion Criteria
- •patient with cardiac or pulmonary disease (ASA class III or more)
- •patient undergone previous spine surgery
- •patient undergoing revised knee replacement
Arms & Interventions
Placebo
8 mg bupivacaine only
Intervention: Placebo
Epi 25
8 mg of bupivacaine mixed with 25 mcg of epinephrine
Intervention: epinephrine 25
Epi 50
8 mg of bupivacaine mixed with 50 mcg of epinephrine
Intervention: Epinephrine 50
Epi 100
8 mg of bupivacaine mixed with 0.1 mg of epinephrine
Intervention: epinephrine 100
Epi 200
intrathecal bupivacaine 8 mg with 200 mcg of epinephrine
Intervention: Epi 200
Outcomes
Primary Outcomes
the sensory level of spinal anesthesia, the quality of intraoperative analgesia
Time Frame: every 15 minutes
at 2, 5, 10, 20, and 30 min after the spinal injection and every 15 minutes thereafter until complete regression of spinal anesthesia.