Sree Kumar EJ, Gautham GANESAN, Arul Murugan RAMASAMY, Janani RAMACHANDRAN

Spinal Anestezide Trunkal Kutanöz Sıcaklık Değişiklikleri ve Antropometri - Gözlemsel Çalışma

Amaç: Spinal anestezide sempatik blok başlangıcının öngörülebi- lirliği düşüktür. Dural kese çevresindeki yapıların, lokal anesteziğin subaraknoid boşluktaki dağılımını belirlemedeki rolü, perispinal frustum hacminin kutanöz sıcaklıktaki değişimi ve soğuk duyusu- nun algısı üzerindeki etkisi incelenerek belirlenmeye çalışılmıştır. Yöntem: İntratekal olarak 2.5 mL %0,5 heavy bupivakain ile spinal anestezi planlanan hastalarda, T8-L3 arasındaki frustum hacmi, T8-L3’teki karın çevresi ve bu spinöz çıkıntılar arasındaki mesafe kullanılarak hesaplandı. T8 seviyesindeki başlama hızı, kutanöz sıcaklık probunda 0,5 °C’lik değişiklik ve soğuk duyusunun kaybı olarak ölçüldü. Bulgular: Analiz edilen 40 hastadan 22’sinde kutanöz sıcaklıkta artış, 14’ünde azalma olurken 4’ünde değişiklik olmadı. Saniye cinsinden soğuk duyu kaybının başlama süresi, kutanöz sıcaklık- ta artış ve azalması olan hastalarda sırasıyla 327,68±169,65 (%99 CI:234,51-420,85) ve 232,64±75,47 (%99 CI:180.69-284.60) idi. Frustum hacminin korelasyon katsayısı (R2), kutanöz sıcaklıkta azal- ma olan grupta 0,55 (%99 CI: -0,15−0,88, p

Truncal Cutaneous Temperature Changes and Anthropometry in Spinal Anaesthesia - An Observational Study

Objective: The predictability of onset of sympathetic block in spi- nal anaesthesia is poor. The role of the structures around the dural sac, in determining the spread of local anaesthetic in the subara- chnoid space, is evaluated by studying the effect of the peri-spinal frustum volume on the change in cutaneous temperature and per- ception of cold sensation. Methods: In patients planned for spinal anaesthesia with 2.5 mL of 0.5% heavy bupivacaine intrathecally, volume of frustum between T8 and L3 was calculated using abdominal circumference at T8 and L3 and the distance between these spinous processes. The speed of onset at T8 level was measured as a change of 0.5 °C in cutaneous temperature probe and loss of cold sensation. Results: Of the 40 patients analysed, 22 patients had increase in cutaneous temperature while 14 had a decrease and 4 had no change. The onset time of loss of cold sensation in seconds was 327.68±169.65 (99% CI:234.51–420.85) and 232.64±75.47 (99% CI 180.69-284.60) in patients with increase and decrease of the skin probe respectively. The square of correlation coefficient (R2 ) of frustum volume was 0.55 (99% CI -0.15-0.88, p=

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