Dawka leku znieczulenia miejscowego na segment rdzeniowy a rozmiary części lędźwiowo-krzyżowej kręgosłupa w znieczuleniu podpajęczynówkowym dorosłych

Krzysztof Duda¹, Andrzej Sokołowski², Agnieszka Kubisz¹, Marek Mizianty¹, Barbara Machowska¹

Summary
Background. The purpose of the study was to calculate the segmental dose (D_R) in a large group of patients receiving spinal anaesthesia, and to analyse how this dose relates to simple anthropometrical measurements, particularly of the lumbo-sacral segment of the spine. Methods. 138 adult patients of both sexes received standardized spinal anaesthesia (same anaesthetic solution, level of injection and patient position) for cancer surgery performed within the lower body. We noted sex, age, body height and weight, spine length, position and length of Tuffier´s line, and the length of the sacral part of the spine (i.e. from the point of Tuffier´s line crossing the spine to the tip of the coccyx). After 30 minutes and stabilization of the level of block, the dose of an anaesthetic agent per segment was calculated. To assess the relationship between the length of the sacral part of the spine on the distribution of the block, multiple regression analysis was performed. Results. It was found that D_R correlated positively with body height and spine length, and negatively – with age and a relative lumbo-sacral segment length, which means that the extent of a block is partly dependent on the morphometry of lumbo-sacral spine. Conclusions. Higher spinal block can be expected with a narrow, or "slim” sacral bone and high lumbar vertebral bodies (high position of intercrestal Tuffier´s line); lower block occurs in patients with a wide pelvis, low, "thick” lumbar vertebrae, low position of the intercrestal line, and a wide sacral bone canal.

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