[Evaluation of the effectiveness of anecaine in central segmental blockades in orthopedic-traumatologic...

Efficacy of anecaine (A) (bupivacaine, Pliva) and marcaine (M) (bupivacaine, Astra) in central neuroaxial block combined with sedation is compared. In the group with epidural block (n = 167, ASA I-III), 102 patients were given anecaine and 65 marcaine in equivalent doses. In the group with spinal block (n = 82, ASA I-III), anecaine was administered to 52 and marcaine to 30 patients. In the epidural block group a catheter was placed at L2-3 or L3-4 with cranial direction. A test dose of bupivacaine (20 mg) was followed after 5-7 min by the main dose of 2 mg.kg-20 mg. Propofol was given for partial suppression of consciousness at a continuous infusion rate 1.6 mg.kg.hr. In spinal block group, bolus dose of bupivacaine (10-20 mg) was injected through the subarachnoidal approach at L2-3 or L3-4. Diazepam (0.1 mg.kg.hr) was used for sedation. Block onset, duration of sensor and motor block, and of effective analgesia were evaluated in all groups. Hemodynamics and respiratory function were monitored. Moderate hypotension (16-17% decline from basic values) was observed in all patients irrespective of bupivacaine brand. In a comparative non-randomized study anecaine showed a faster onset of block and longer duration of clinical effect than marcaine in epidural and spinal anesthesia for orthopedic surgery on the lower limbs.