مقايسه طول بي دردي و تغييرات فشارخون در بلوك زين اسبي با ليدوكايين و بوپيواكايين

COMPARISON OF DURATION OF PAINLESS PERIOD AND VARIATION OF BLOOD PRESSURE IN SADDLE BLOCK WITH LIDOCAINE AND BUPIVACAINE

OBJECTIVE: Saddle block in anorectical, some urologic and gynecologic procedures provide suitable condition for surgeon due to sufficient analgesia and decreases side effects of spinal anesthesia. In this study, duration of painless period and hemodynamic changes in saddle block with lidocaine (intermediate acting) and bupivacaine (long acting) were compared. METHODS: This study was conducted on 51 cases in ASA class 1 (American society of anesthesiologists) 15-65 years old who had no co-existing disease. They were randomly divided into two groups. Before starting of saddle block all patients received 500ml crystalloid solution. Saddle block was done in the first group (26 cases) with lidocaine 5% (1 ml) and in the second group (25 cases) with bupivacaine 0.5% (lml), with a 25- gauge spinal needle. Systolic and diastolic blood pressure were measured and recorded 5 minutes before the block (baseline) and at 5th , 15th and 60th minutes after the block and then data were compared. FINDINGS: After saddle block, systolic blood pressure in both groups decreased. This change in the first group was more intensive than the second group. The difference of systolic blood pressure between two groups only in the first 5 minutes was significant (p- 0.047). Variation of diastolic blood pressure after saddle block in both groups was more stable and there was not a significant difference between them. The mean of duration of painless period after block in the first group was 197.3 minutes and in the second group was 345.2 minutes, showing a significant difference (p<0.0001). CONCLUSION: The results showed that hemodynamic stability and painless period in patients who received bupivacaine were more than those who received lidocaine. Therefore, bupivacaine can be used instead of lidocaine in saddle block.