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    Single shot "3-in-1" femoral nerve blockade with 0.25% or 0.375% levobupivacaine provides similar postoperative analgesia for total knee replacement
    (Tubitak Scientific & Technical Research Council Turkey, 2010) Apan, Alpaslan; Sari, Filiz; Ekmekci, Alp Burak
    Aim: To compare postoperative analgesia provided by single shot "3-in-1" femoral nerve blockade using 0.25% or 0.375% levobupivacaine in preceding with spinal anesthesia for unilateral total knee replacement surgery. Materials and methods: Forty consenting patients undergoing unilateral total knee arthroplasty were included in this prospective randomized study. Spinal anesthesia was achieved with 15 mg plain bupivacaine at the L3-4 or L4-5 interspace. After resolution of the spinal anesthesia, patients were randomized into 2 groups: "3-in-1" femoral nerve blocks were performed using 30 m L of 0.25% levobupivacaine (Group 1, n = 20) or 0.375% levobupivacaine (Group 2, n = 20). Pain was assessed by visual analogue scale (VAS). The total morphine consumption and the side effect profile were compared during the postoperative period. Results: There were no significant differences between the 2 study groups with respect to characteristics or intraoperative variables. Furthermore, sensory block periods and time to first pain sensation, VAS, and morphine consumption for 24 h (Group 1: 19.7 +/- 9.2, Group 2:20.6 +/- 12.1 mg) were similar. Pain scales and range of motion during rehabilitation period and side effects were also comparable. Conclusion: Our results indicate that the augmenting concentration did not influence the clinical outcome when single shot "3-in-1" femoral nerve block was performed with 0.25% or 0.375% levobupivacaine in total knee arthroplasty.
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    Öğe
    The effects of lactated ringer and hes solutions in differing combinations to prevent hypotension due to spinal anesthesia
    (2006) Şahin, Şaziye; Sari, Filiz; Apan, Alpaslan; Başar, Hülya
    Objective: The aim of this study was to assess the effectiveness of preloading with crystalloid and colloid fluids on hypotension following spinal anaesthesia. Method: One hundred ASA Class I-II patients were randomly assigned to the study and divided into five groups. Group I: Lactated Ringer (LR) 1000 mL 30 minutes before spinal anaesthesia, Group II: HES %6 500 mL solution before the procedure, Group III: 500 mL RL before and HES %6 250 mL within 15 minutes after the procedure. Group IV and Group V received RL 500 mL + 500 RL mL, and HES %6 250 mL + HES %6 250 mL respectively, using the same timing protocol. Systolic, diastolic and mean arterial pressures and heart rates were measured at 1 minute intervals in the first 20 minutes and then every 5 minutes. Results: With the exception of the differences in diastolic blood pressures at the 2nd, 3rd, and 5th minutes, there was no difference in arterial blood pressures and heart rates between Group III and IV or Group IV and V. Conclusion: While significant correlation was found between spinal block level and the incidence of spinal hypotension, no difference was observed regarding the type, dosage, and timing of loading solutions before spinal anaesthesia.