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Circadian Effects on Neural Blockade of Intrathecal Hyperbaric Bupivacaine

BACKGROUND: Circadian variations in the absorption, distribution, protein binding, elimination and metabolism of drugs account for many of the administration-time-dependent differences in their pharmacokinetics. The aim of this study is to determine whether the time of intrathecal injection influenc...

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Detalles Bibliográficos
Autores principales: Lee, Cheol, Choi, Deok Hwa, Chae, Soo Uk
Formato: Texto
Lenguaje:English
Publicado: The Korean Pain Society 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935980/
https://www.ncbi.nlm.nih.gov/pubmed/20830264
http://dx.doi.org/10.3344/kjp.2010.23.3.186
Descripción
Sumario:BACKGROUND: Circadian variations in the absorption, distribution, protein binding, elimination and metabolism of drugs account for many of the administration-time-dependent differences in their pharmacokinetics. The aim of this study is to determine whether the time of intrathecal injection influences spinal anesthesia. METHODS: Ninety patients scheduled for orthopedic surgery were randomly assigned to three groups. Each group received spinal anesthesia with 0.5% bupivacaine 10 mg at different times; group AM (8 am to 12:00), group Noon (12:00 to 4:00 pm) and group PM (4:00 pm to 8:00 pm). Sensory and motor blockade were assessed by pinprick and a four-point modified Bromage scale. Time to first postoperative analgesic requirement and side effects such as hypotension, bradycardia, nausea, and shivering were recorded. RESULTS: No significant differences were found among the three groups in peak sensory blockade, duration of motor block to Bromage 1 or side effects, but time to first postoperative analgesic requirement (P = 0.008), and recovery time of S1 sensation to pinprick were significantly prolonged in group Noon compared with the other groups (P = 0.03). CONCLUSIONS: The tine of administration of spinal local anesthetics influences the duration of local anesthesia.