مقايسه تاثير تزريق اپيدورال نرمال سالين با بيكربنات سديم بر مدت بي حسي حاصل از تزريق اپيدورال هيدوكايين 2 در بيماران تحت جراحي شكستگي استخوان ران

Comparing the Effect of Normal Saline and Sodium Bicarbonate On Duration of Anesthesia Following Epidural Anesthesia by Lidocaine 2% in Patients with Femoral Fracture

Introduction: Epidural anesthesia is one of effective regional anesthesia methods for different kinds of (small and large) surgeries. Prolongation of sensory and motor block following epidural anesthesia is accompanied by long stay in PACU and more post anesthesia care requirements. One of the essential needs is limiting hospital stay and decreasing epidural anesthesia side effects. Therefore, using methods that can cause early discharge and reduce sensory-motor and sympathetic blockade period are necessary. Using crystalloid solutions is one of these methods. Objective: In this study the researcher tried to compare the effectiveness of two crystalloid solutions - normal saline and sodium bicarbonate solution - to access the best method. Materials and Methods: This research is a randomized double blind clinical trial study. Sixty ASA-II patients who had repairing surgery for fracture of femor were divided into two equal groups (thirty patients in each group), And all of them received 20m1 lidocaine 2% through epidural catheter insertion. In the end of surgery, the patient was transported to recovery room and 15m1 crystalloid solution - normal saline or sodium bicarbonate - was injected and then catheter was removed. The level of sensory blockage based on blocked spinal and motor blockage were examined and registered every 15 minutes by Bromage scale (zero-none, 1-motor blockage of hip, 2=hip and knee block, 3=ankle, hip and knee block). Data was analyzed by t-test and Anova tests by SPSS.10 software. Results: The mean age in normal saline group was 41± 12 and in sodium bicarbonate group was 43+11 years. There were 13 female and 17 males in normal saline group and 15 female and 15 males in sodium bicarbonate group. The mean of regression time of sensory block of sodium bicarbonate was 92min and 50sec, and due to normal saline was 99min and 25sec. The regression time of motor block due to sodium bicarbonate was 89min and 25sec, and due to normal saline was 94min and 50sec. All results were significant (P<0.05). The regression of sensory and motor block due to sodium bicarbonate was more rapid than normal saline. Any side effect was not detected. Conclusion: According to data obtained, it seems that using sodium bicarbonate as compared to normal saline at the end of femoral surgery improves sensory-motor blockade sensation due to injection of Lidocaine 2%soution and educes PACU stay period and improves anesthesia tolerance. This method could be used for all patients whom receive epidural anesthesia.