A comparison of intrathecal bupivacaine,isobaric,hyberbaric and/or isobaric forms in vaginal hysterectomy [Vajinal hi̇sterektomi̇lerde i̇ntratekal bupi̇vakai̇ ni̇n,i̇zobaṙik ve/veya ḣiperbȧrik formlarinin ķarşilastirilmasi]

Objective: the aim of this study was to demonstrate whether addition of intrathecal morphine to either isobaric,hyperbaric or isobaric+hyperbaric bupivacaine during spinal anesthesia would he superior for the the sensory and motor block characteristics,hemodynamic stability,side effects,complications and postoperative first analgesic requirement during vaginal hysterectomy. method: after monitoring heart rate (hr) and mean arterial pressure (map) of the 48 asa i-iii patients aged between 40-70 years having no contraindication for regional anesthesia,they were randomly assigned to three groups. intratechal morphine 100 μg was administered with either hyperbaric bupivacaine 15 mg % 0.5 (group h) or isobaric bupivacaine 75 mg % 0.5 + hyperbaric bupivacaine 7.5 mg (1.5 ml) % 0.5 (group h+p) or isobaric bupivacaine 15 mg % 0.5 (group p). results: ephedrine requirement and total amount of ephedrine used were comparable among the groups. although hr values did not differ among the groups at all times,according to the comparison of map values of the groups,measurements at 15 minutes in both groups h+p and p were significantly higher than in group h (p=0.0166). measurements at 20 and 25th minutes in group h+p were significantly higher than in group h (p<0.0166). while sensory block reached t6 in all patients of the group h,it was at t8 in only 2 patients from groups p and group h+p,respectively. motor block in group h+p developed later compared to group h (p<0.05). perioperative and postoperative complications,first analgesic requirement,mobilization and flatulans times were not significantly different among the groups. conclusion: since similar sensory and motor block characteristics,hemodynamic stability,and perioperative and postoperative follow up due to administration of morphine 100 μg as an adjuvant with hyperbaric,isobaric or hyperbaric + isobaric bupivacaine were achieved; all three solutions can be used successfully for spinal anesthesia during vaginal hysterectomy.