Effect of Intrathecal Bupivacaine Lidocaine combination on Motor Block ,Analgesia Period and side effect profile

Objectives: 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 required, the hemodynamic side effect & neurological complications especially transient neurological symptoms (TNS).

Methods: Ninety patients who were scheduled for elective lower abdominal , anal surgery& Knee arthroscopy under spinal anesthesia were randomly allocated into three equal groups (30 patients each)Group I (control group): 1.5ml hyperbaric 0.5% Bupivacaine + 0.6mL saline).Group II :(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 sensory block, motor blocks at peak sensory block &total motor block duration ,PACU time, analgesia time ,analgesia consumption, hemodynamic side effect & neurological complication were measured

Results:

The median height of peak sensory block in Group III was higher than in Groups I or II. Times to two-segment regressions and S2 regressions from peak sensory block, motor block duration and PACU time were significantly reduced in Group II compared to Group I & III. No patient required general anesthesia. No patients experienced postdural puncture headache, TNS or other side effect.

Conclusion: :  0.6mL 1% Lidocaine (6 mg) mixed to spinal 1.5ml hyperbaric 0.5% Bupivacaine (7.5 mg) can shorten the duration of Bupivacaine spinal anesthesia, therefore provide more rapid recovery from the spinal anesthesia