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British Journal of Anaesthesia, 2001, Vol. 86, No. 2 245-248
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Rate of injection through Whitacre needles affects distribution of spinal anaesthesia

L. Anderson, J. Walker, C. Brydon and M. G. Serpell

Department of Anaesthesia, Western Infirmary, Glasgow G11 6NT, UK*Corresponding author

A prospective, randomized, double-blind study was performed to investigate whether altering the rate of injection of local anaesthetic through a Whitacre needle had any effect on the spinal block achieved. Twenty patients scheduled for elective urological surgery under spinal anaesthesia received an injection of 3 ml of 0.5% plain bupivacaine either by hand (fast) over 10 s (18 ml min–1) or by infusion pump (slow) over 3 min (1 ml min–1). All patients were in the sitting position both during insertion of the spinal needle and for 3 min after the start of spinal injection, and they then changed to the supine position. The slow injection group achieved peak sensory block earlier, after a median interval of 20 (95% confidence interval 12.5–30) min vs 30 (22.5–45) min (P<0.05) for the fast group. The level of peak sensory block was similar: T3.5 (T2–T4.5) vs T4 (T1.5–T6.5). The time to lowest mean arterial pressure occurred earlier in the slow group, at 10 (8 to 18) vs 20 (15–31) min (P<0.05). Duration of the motor block was shorter in the slow group: 180 (152–242) vs 270 (225–300). We conclude that a slow spinal injection of plain bupivacaine results in a block of more rapid onset and recovery.

Br J Anaesth 2001; 86: 245–8


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