Comparison of hyperbaric and plain bupivacaine with hyperbaric cinchocaine as spinal anaesthetic agents

Abstract

In a double‐blind study, 90 patients (ASA 1 or 2) received spinal anaesthesia with 2 ml hyperbaric cinchocaine 0.5%, 4 ml hyperbaric bupivacaine 0.5% or 4 ml plain bupivacaine 0.5%. All injections were made in the left lateral position, and the patients turned supine immediately. Hyperbaric bupivacaine produced a significantly faster and a higher dermatomal level of bilateral complete sensory blockade than the other solutions (p < 0.005 for each). The duration of sensory blockade was significantly longer with plain bupivacaine than with either hyperbaric solution (p < 0.0005). The intensity of sensory blockade was significantly greater with both bupivacaine solutions than with hyperbaric cinchocaine (p < 0.05). Onset and intensity of motor blockade were similar with all agents, but motor blockade was of significantly shorter duration with hyperbaric bupivacaine than the other agents (p < 0.0005). Hyperbaric bupivacaine appears to be the best agent for rapid and intense sensory blockade of intermediate duration. Plain bupivacaine is more appropriate if a longer duration of action but a lower height of blockade are required, and has the advantage of less cardiovascular disturbance. Copyright © 1989, Wiley Blackwell. All rights reserved