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

• Published in: European journal of anaesthesiology Vol. 25; no. 12; pp. 1014 - 1019
• Main Authors: Echevarria, M., Hachero, A., Martinez, A., Ramallo, E., García-Bernal, D., Ramos, M., Fernández, A.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-12-2008; European Society of Anaesthesiology; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Aged; Anesthesia, Spinal - methods; Anesthetics, Local - administration & dosage; Bupivacaine - administration & dosage; Cerebrospinal Fluid - chemistry; Cerebrospinal Fluid Proteins - analysis; Diabetes Mellitus - cerebrospinal fluid; Elective Surgical Procedures; Electrolytes - blood; Electrolytes - cerebrospinal fluid; Female; Glucose - analysis; Glucose - cerebrospinal fluid; Humans; Immunoglobulin G - blood; Immunoglobulin G - cerebrospinal fluid; Male; Middle Aged; Motor Activity - drug effects; Osmolar Concentration; Prospective Studies; Sensation - drug effects; Treatment Outcome; CEREBROSPINAL FLUID; BUPIVACAINE; SPINAL ANAESTHESIA; DIABETES MELLITUS
• ISSN: 0265-0215; 1365-2346
• DOI: 10.1017/S0265021508004729

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.