Density and spread of commonly
used intrathecal agents in a cerebrospinal fluid model
Málek J.1, Rosina J.2, Samcová E.3, Kurzová A.1, Starec M.2
1Klinika anesteziologie a resuscitace UK Praha, 3. LF a FNKV Praha, 2Ústav lékařské biofyziky a informatiky UK Praha, 3. LF, 3Ústav lékařské chemie a biochemie UK Praha, 3. LF |
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Summary:
Purpose. This study was performed to determine whether the addition of opioids alters the density and
spread of intrathecal anaesthetics in vitro.Methods. InPart 1 the densities of the commercially available
local anaesthetics bupivacaine, articaine, ropivacaine, opioids fentanyl, sufentanil, morphine and their
mixtures were measured at 24 °C. In Part 2 a model filled with artificial analogue of a cerebrospinal
fluid (CSF) warmed to 37 °C was elaborated. Samples from Part 1 coloured with methylene blue at room
temperature were injected into the model at controlled rate through spinal needle and extent of their
distribution in CSF was measured. Results. Densities of all solutions at 24 °C were higher than the
known density of CSF at 37 °C. The spread of isobaric local anaesthetics without or with opioids was
symmetrical from the point of injection except of articaine and its mixtures, which had slightly more
downward direction (p<0.05). Spread of all hyperbaric anaesthetics or their mixtures had downward
direction. Conclusions. We can conclude that admixture of opioids with commercial local anaesthetics
does not change their physical characteristics and from this point of view seems to be clinically safe.
Key words:
spinal canal model, intrathecal drugs, local anaesthetics, opioids
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