Skip Navigation


BJA Advance Access originally published online on June 23, 2006
British Journal of Anaesthesia 2006 97(3):393-400; doi:10.1093/bja/ael147
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
97/3/393    most recent
ael147v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Förster, J. G.
Right arrow Articles by Niemi, T. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Förster, J. G.
Right arrow Articles by Niemi, T. T.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Continuous spinal microcatheter (28 gauge) technique for arterial bypass surgery of the lower extremities and comparison of ropivacaine with or without morphine for postoperative analgesia{dagger}

J. G. Förster*, P. H. Rosenberg and T. T. Niemi

Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital PB 340, FIN 00029 Helsinki, Finland

*Corresponding author. E-mail: johannes.forster{at}fimnet.fi

Background. The aim of this study was to evaluate a microcatheter technique for continuous spinal anaesthesia (CSA) and continuous spinal postoperative analgesia (CSPA) in vascular surgery.

Methods. A total of 47 patients (range 51–95 yr, ASA II–IV) undergoing peripheral bypass surgery of the lower extremities received a spinal microcatheter (28 gauge) at L3–L4 or L2–L3. For CSA, ropivacaine 7.5 mg ml–1 was given in small increments. Central venous pressure was maintained ≥3 mm Hg. Of 47 patients, 44 received CSPA, either using ropivacaine alone 2 mg h–1 (group R, n=22) or ropivacaine 1 mg h–1 with morphine 8 µg h–1 (group RM, n=22) for 24 h after surgery (randomized, double-blinded).

Results. Intraoperative haemodynamic control was good; during the initial 60 min only four patients received phenylephrine i.v. for hypotension. Up to 30% of the patients felt mild pain at incision but surgery [mean duration 173 min (range 66–327)] was successfully completed under CSA in 45 patients. In four instances of acute revision surgery, a new block was administered utilizing the spinal catheter in place. Postoperative pain relief was comparably adequate in both groups with no difference in rescue pain medication. Four patients (three in R, one in RM) had weak motor blockade in the first postoperative morning.

Conclusions. The described CSA technique offered good haemodynamic control, ease of maintaining spinal anaesthesia, and ease of providing a new spinal block for revision. The combination of low-dose ropivacaine and morphine for CSPA did not offer any benefit compared with the higher ropivacaine dose alone.

{dagger}Presented in part at the 28th Congress of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, Reykjavik, Iceland, June 29–July 3, 2005


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.