Comparison of the effects of single dose and continuous levobupivacaine used in spinal anesthesia for transurethral resection

This study aimed to compare the effects of intratecal levobupivacaine applied with two different techniques on the anesthesia and hemodynamics in transurethral resectionSixty geriatric patients of ASA ??-??? risk group were divided into two groups as single dose spinal anesthesia group (Group TDSA) and continuous spinal anesthesia (Group SSA) groups. Then, 0.5% levobupivacaine was intratecally titrated to TDSA group at a dose of 12,5 mg, and to SSA group at doses of 5, 2.5, 2.5?mg by catheter method over the needle. In SSA group, the amount of local anesthesia used for surgical intervention was significantly lower. The median value for maximum sensory blockade was T8 for TDSA group and T9 for SSA group. The time to attain sensory blockade level of T10 and maximum sensory blockade was significantly longer in SSA group. No differences were determined between the two groups for two segment regression and ending times and starting and ending times of motor blockade. Peropretaively, heart beat rate was lower than the control values after the 25th minute in TDSA group and after the 40th minute in TDSA group. In the peroperative and postoperative period, no statistically significant differences were determined between the groups for prevalence of hypotension and bradycardia. In TDSA group, the patients in whom high sensory blockade was achieved in a shorter time developed hypotension, while slowly developing sensory blockade in SSA group prevented hypotension development. In SSA group, the rate of parestesia development during the intervention was significantly higher than in TDSA groupIn conclusion, in geriatric patients, whose physiological adaptation mechanisms are slower, intratecal levobupivacaine, when administered by SSA technique, provides a slower rate for reaching the maximum sensory blockade and stable hemodynamics; thus, it is a reliable agent.