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BioMed Research International

BioMed Research International
Article ID 453939

Clinical Study

The Levels and Duration of Sensory and Motor Blockades of Spinal Anesthesia in Obese Patients That Underwent Urological Operations in the Lithotomy Position

1Department of Anesthesiology and Reanimation, Dicle University Medical Faculty, 21280 Diyarbakır, Turkey
2Department of Anesthesiology and Reanimation, Kilis State Hospital, Kilis, Turkey
3Department of Anesthesiology and Reanimation, Istinye State Hospital, Istanbul, Turkey
4Department of Anesthesiology and Reanimation, Bezmialem Vakif University, Istanbul, Turkey
5Department of Internal Medicine, Trakya University Medical Faculty, Edirne, Turkey

Received 13 June 2014; Accepted 14 December 2014

Academic Editor: Patricia Khashayar

Copyright © Taner Ciftci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Obesity has a significant effect on the cephalic spread of a spinal block (SB) due to a reduction in cerebrospinal fluid (CSF). SB is controlled by the tissue blood flow in addition to the CSF. Some positions and techniques of surgery used can cause changes in hemodynamics. We investigated effects of hemodynamic changes that may occur during Transurethral prostate resection (TUR-P) and lithotomy position (LP) at the SB level in obese versus nonobese individuals. Sixty patients who had undergone TUR-P operation under spinal anesthesia were divided into a nonobese ( kg/m2, Group N) or obese ( kg/m2, Group O) group. SB assessments were recorded afterthe LP. SB at 6 and 120 min and the peak SB level were compared between two groups. Hemodynamics were recorded after LP. Peak and 6 min SB levels were similar between the groups, while 120 min SB levels were significantly higher for Group O (). Blood pressure (BP) after the LP was significantly higher for Group N (). LP and TUR-P increased the BP in Group N when compared to Group O. The increase in hemodynamics enhances the blood flow in the spinal cord and may form similar SB levels in nonobese patients to those in obese patients. However, SB time may be longer in obese patients.

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Doç. Dr. Ali Bestami Kepekçi