Effect of intrathecal Bupivacaine–Lidocaine combination on motor block and analgesia period

ObjectiveTo assess the effect of intrathecal Bupivacain–Lidocaine combination at different doses of Lidocaine (6 and 12 mg) on the onset and recovery of anesthesia.MethodsNinety patients who were scheduled for elective lower abdominal surgery were randomly allocated into three equal groups: Group I; 30 patients received 1.5 mL hyperbaric 0.5% Bupivacaine + 0.6 mL saline. Group II; 30 patients received 1.5 mL hyperbaric 0.5% Bupivacaine + 0.6 mL 1% Lidocaine [6 mg] mixed. Group III; 30 patients received 1.5 mL hyperbaric 0.5% Bupivacaine + 0.6 mL 2% Lidocaine [12 mg]. Peak sensory block level, time to peak sensory block, times to two-segment, S2 regressions from peak sensory block, motor blocks at peak sensory block and total motor block duration, post anesthesia care unit stay time and analgesia time were measured.ResultsThe median height of peak sensory block in Group III was higher than in Group I or II. Times to two-segment and S2 regressions from peak sensory block, motor block duration and PACU time were significantly reduced in Group II compared to Group I and III. No patient required general anesthesia. No patients experienced postdural puncture headache or TNS.ConclusionsLidocaine 1% (6 mg) mixed to spinal 1.5 mL hyperbaric 0.5% Bupivacaine (7.5 mg) can shorten the duration of Bupivacaine spinal anesthesia, provide more rapid recovery from the spinal anesthesia compared to the same dose of 0.5% Bupivacaine (7.5 mg) alone or the same dose of 0.5% Bupivacaine (7.5 mg) mixed with 0.6 mL 2% Lidocaine (12 mg).