[Spinal anesthesia with bupivacaine. Comparative study of 2 hyperbaric and isobaric solutions]

This study compared two isobaric and hyperbaric solutions of 0.4% bupivacaine used for carrying out spinal anaesthesia in 264 patients more than 70 years old undergoing comparable surgical procedures. With the hyperbaric solution, the mean time of onset of analgesia was shorter: 8.4 +/- 4 min (11.5 +/- 5.1 min with the isobaric solution), the level of analgesia higher by two dermatomes and the mean duration of analgesia longer: 147.3 +/- 24.8 min (121.1 +/- 24.8 min with the isobaric solution). Blood pressure fell more often with the hyperbaric solution. The motor block, assessed by the inability to move the legs and abdominal wall paralysis, was more complete with the hyperbaric solution. Lastly, there were less failures: 3.4% with hyperbaric solution and 12.1% with isobaric solution.