Onset response of bupivacaine 0.5% which has been added with sodium bicarbonate on epidural block

Abstract

There are many advantages in using epidural anesthesia technique. However, there are also some constraints, such as the relatively long onset, particularly in the case of bupivacaine. Whereas the need of a rapid onset of anesthesia technique for emergency cares is increasing lately. The objective of this study was to find a method to hasten the onset of bupivacaine. This is a cross sectional randomized double blind controlled clinical trial performed on 40 patients who would undergo lower abdomen and extremity surgery with epidural block. We evaluated the onset of action of bupivacaine which has been added with sodium bicarbonate. Consecutive sampling method was applied to get the sample. The criteria of sample are ASA I - II patient, aged of 20-60 years old, 50-60 kg of weight, 150-170 cm of height. Patients were allocated randomly into two groups. The treatment group would get epidural block using mixture of 20 cc of bupivacaine 0,5 % + 0.5 cc of sodium bicarbonate 1.4 %, whereas the control group received 20 cc bupivacaine 0.5 % + 0.5 cc aqua bides. Time to reach sensoric block at the level of thoracal 10 dermatome using the pinprick method and time to reach motoric blockade using the bromage scale was recorded. The result of this study showed a significant shortening of the onset of sensory blockade (p< 0.05) in the treatment group (10.2± 1.4 minutes) compared with the control group (19.5± 1.3 minutes). The onset of motor blockade had also a significant shortening (p< 0.05) in the treatment group(13.3± 1.6 minutes) compared with the control group (23.0± 1.2 minutes). It was concluded that the addition of sodium bicarbonate can hasten the onset of bupivacaine on epidural block.