Jasinski Tomasz, Migon Dorian, Sporysz Krystian, Kamysz Wojciech, Owczuk Radoslaw
Department of Anesthesiology and Intensive Therapy, Medical University of Gdansk, 80-214 Gdansk, Poland.
Department of Inorganic Chemistry, Medical University of Gdansk, 80-416 Gdansk, Poland.
Pharmaceuticals (Basel). 2021 Aug 16;14(8):801. doi: 10.3390/ph14080801.
Various opioids are added to local anesthetic solutions for spinal anesthesia. This may change the final density of the local anestetic (LA) mixture. This effect regarding current concepts in spinal anesthesia needs to be re-evaluated. In order to re-evaluate such effects, hyperbaric and isobaric local anesthetic (LA) solutions were mixed with opioid adjuvants (A) using the equipment available in the operating room. Ten density measurements for each composition (LA-A) were performed. The density change of 0.0006 g/mL was regarded as significant. Measured densities were also compared with theoretical values calculated using Hare's. As a result, the addition of an opioid adjuvant caused a significant reduction in the final density of the LA-A solution. In hyperbaric LA mixtures, it did not change the baricity from hyperbaric to isobaric. However, the addition of highly hypobaric fentanyl 0.99360 g/mL (SD ± 0.00004) changes all isobaric LA solutions baricity to hypobaric. The comparison of measured and theoretical densities revealed significant differences ( > 0.05). However, the absolute reduction reached 0.0006 g/mL in only two LA-A compositions. We conclude that the addition of fentanyl to isobaric LA results in a hypobaric solution that may affect the distribution of the block. The inadequacy of LA-A in a clinical setting is unlikely to influence block characteristics.
各种阿片类药物被添加到用于脊髓麻醉的局部麻醉溶液中。这可能会改变局部麻醉剂（LA）混合物的最终密度。关于脊髓麻醉当前概念的这种影响需要重新评估。为了重新评估这种影响，使用手术室现有的设备将高压和等压局部麻醉剂（LA）溶液与阿片类佐剂（A）混合。对每种组合物（LA - A）进行了十次密度测量。密度变化0.0006 g/mL被视为具有显著性。还将测量的密度与使用黑尔公式计算的理论值进行了比较。结果，添加阿片类佐剂导致LA - A溶液的最终密度显著降低。在高压LA混合物中，它并没有使比重从高压变为等压。然而，添加高比重的芬太尼0.99360 g/mL（标准差±0.00004）会使所有等压LA溶液的比重变为低比重。测量密度与理论密度的比较显示出显著差异（>0.05）。然而，只有两种LA - A组合物的绝对降低达到了0.0006 g/mL。我们得出结论，向等压LA中添加芬太尼会产生一种低比重溶液，这可能会影响阻滞的分布。在临床环境中LA - A的不足不太可能影响阻滞特征。
