Effect of Intrathecal Bupivacaine Lidocaine combination on Motor Block and Analgesia Period

Purpose: Assessing the effect of intrathecal Bupivacain-Lidocaine combination at different doses of Lidocaine (6mg & 12mg) on the onset &recovery of anesthesia; times to retain motor ability, postoperative analgesia, the hemodynamic side effect & neurological complications especially transient neurological symptoms (TNS).

Methods: : Ninety adult patients who were scheduled for elective lower abdominal , anal or Knee arthroscopy surgery under spinal anesthesia were randomly allocated into three groups (30 patients each) Group I (control group): (1.5ml hyperbaric 0.5% Bupivacaine + 0.6mL saline). GroupII:(1.5mL hyperbaric 0.5 %Bupivacaine + 0.6mL 1% Lidocaine[6mg]). Group III: (1.5mL hyperbaric 0.5 % Bupivacaine + 0.6mL 2% Lidocaine[12mg]). Peak sensory block level, times to peak sensory block, times to two-segment regression, S2 regressions from peak , motor block degeree at peak sensory block , motor block duration ,PACU time, analgesia time ,analgesia consumption, hemodynamic side effect & neurological complication were measured.

Results: The median height of peak &the times to peak sensory block in Group III was higher than in Groups I or II. Times to 2 segment regressions and S2 regressions from peak, motor block duration and PACU time were significantly reduced in Group II compared to Group I & III. No patient required general anesthesia or experienced TNS.

Conclusion: We conclude that 0.6mL 1% Lidocaine plus 1.5ml 0.5% Bupivacaine (7.5 mg) can shorten the duration of the spinal anesthesia providing more rapid recovery.