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Spinal anaesthesia with 0.5% isobaric bupivacaine in patients with diabetes mellitus: the influence of CSF composition on sensory and motor block

Published online by Cambridge University Press:  01 December 2008

M. Echevarria ,
A. Hachero ,
A. Martinez ,
E. Ramallo ,
D. García-Bernal ,
M. Ramos  and
A. Fernández
M. Echevarria*
Affiliation:
Valme University Hospital, Departament of Anaesthesiology, Seville, Spain
A. Hachero
Affiliation:
Valme University Hospital, Departament of Anaesthesiology, Seville, Spain
A. Martinez
Affiliation:
Valme University Hospital, Departament of Anaesthesiology, Seville, Spain
E. Ramallo
Affiliation:
Valme University Hospital, Departament of Clinical Análisis, Seville, Spain
D. García-Bernal
Affiliation:
Valme University Hospital, Departament of Anaesthesiology, Seville, Spain
M. Ramos
Affiliation:
Valme University Hospital, Departament of Anaesthesiology, Seville, Spain
A. Fernández
Affiliation:
Valme University Hospital, University of Sevilla, Department of Biostatistics, Seville, Spain
*
Correspondence to: Mercedes Echevarria, Departamento de Anestesiología y Reanimación, Hospital Universitario de Valme, Carreterea de Cadiz s/n, Sevilla 14041, Spain. E-mail: MERCEDES.ETXEBA@terra.es; Tel/Fax: +349 550 15688
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Summary

Background and objective

We investigated cerebrospinal fluid characteristics in patients with and without diabetes mellitus and the influences that changes in these characteristics have on sensory and motor block when spinal anaesthesia is performed.

Methods

We included 44 patients in each study group. All received spinal administration of 15 mg of 0.5% isobaric bupivacaine. Blood and cerebrospinal fluid were analysed for glucose, total protein, urea, albumin, immunoglobulin G, sodium, chloride, potassium, calcium, magnesium and osmolarity as well as the performance of the local anaesthetic from establishment until complete regression of sensory and motor block.

Results

The cerebrospinal fluid of the two groups differed significantly (P < 0.05) in the levels of total protein, albumin, immunoglobulin G, glucose and osmolarity. Sensory and motor block was established more rapidly in the diabetic group (P < 0.05), and the total duration from maximum block until regression to two dermatomes was greater (P < 0.05), as was the complete regression from sensory and motor block (P < 0.05).

Conclusion

This study shows that diabetes mellitus has an influence on sensory and motor block after the administration of spinal isobaric bupivacaine.

Keywords

SPINAL ANAESTHESIADIABETES MELLITUSCEREBROSPINAL FLUIDBUPIVACAINE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 12 , December 2008 , pp. 1014 - 1019
Copyright
Copyright © European Society of Anaesthesiology 2008

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