Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpator

Argyro Fassoulaki, Konstantinos D. Sarantopoulos, Marianna Zotou, George Karabinis

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

In a cross-over study we compared two methods of assessing the level of sensory block during subarachnoid anesthesia: the traditional pinprick sensation or a novel pressure palpator exerting a pressure of 650 g. Fifty patients scheduled for transurethral surgery under subarachnoid anesthesia were randomly assigned to be tested for spread of sensory block. In Group 1, the pressure palpator was followed by pinprick; in Group 2, the reverse sequence was used. Evaluation was performed 15 and 25 min after the subarachnoid injection of 2 mL of 5% lidocaine hyperbaric solution. In Group 1, the level of sensory block assessed with the pressure palpator was 1.7 ± 3.2 cm (0.5 ± 1.2 dermatomes) higher than that with the pinprick at 15 min, and 2.2 ± 3.4 cm (0.6 ± 1.0 dermatomes) higher than that with the pinprick 25 min after the block. In Group 2, the difference was accentuated. The level of sensory block assessed by pinprick 15 min after subarachnoid lidocaine was 5.7 ± 4.8 cm (12 ± 0.9 dermatomes) lower than the level with the pressure palpator, and 4.2 ± 3.3 cm (0.9 ± 0.6 dermatomes) lower than that with the pressure palpator at 25 min. In all instances, the pressure palpator gave a significantly higher assessment than the pinprick. We conclude that the pressure palpator, when preceded by the pinprick test, is associated with an increased threshold. This method may be useful in assessing the sensory block produced by subarachnoid anesthesia. Implications: A novel pressure palpator that maintains the integrity of the epidermis was used to assess the level of sensory block after subarachnoid anesthesia and was compared with the standard method of the pinprick sensation. This method assessed the block consistently higher than the pinprick method, but it may have advantages as a noninvasive sensory test.

Original languageEnglish
Pages (from-to)398-401
Number of pages4
JournalAnesthesia and Analgesia
Volume88
Issue number2
DOIs
StatePublished - Feb 1 1999
Externally publishedYes

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Anesthesia
Pressure
Lidocaine
Epidermis
Cross-Over Studies
Injections

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpator. / Fassoulaki, Argyro; Sarantopoulos, Konstantinos D.; Zotou, Marianna; Karabinis, George.

In: Anesthesia and Analgesia, Vol. 88, No. 2, 01.02.1999, p. 398-401.

Research output: Contribution to journalArticle

Fassoulaki, Argyro ; Sarantopoulos, Konstantinos D. ; Zotou, Marianna ; Karabinis, George. / Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpator. In: Anesthesia and Analgesia. 1999 ; Vol. 88, No. 2. pp. 398-401.
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abstract = "In a cross-over study we compared two methods of assessing the level of sensory block during subarachnoid anesthesia: the traditional pinprick sensation or a novel pressure palpator exerting a pressure of 650 g. Fifty patients scheduled for transurethral surgery under subarachnoid anesthesia were randomly assigned to be tested for spread of sensory block. In Group 1, the pressure palpator was followed by pinprick; in Group 2, the reverse sequence was used. Evaluation was performed 15 and 25 min after the subarachnoid injection of 2 mL of 5{\%} lidocaine hyperbaric solution. In Group 1, the level of sensory block assessed with the pressure palpator was 1.7 ± 3.2 cm (0.5 ± 1.2 dermatomes) higher than that with the pinprick at 15 min, and 2.2 ± 3.4 cm (0.6 ± 1.0 dermatomes) higher than that with the pinprick 25 min after the block. In Group 2, the difference was accentuated. The level of sensory block assessed by pinprick 15 min after subarachnoid lidocaine was 5.7 ± 4.8 cm (12 ± 0.9 dermatomes) lower than the level with the pressure palpator, and 4.2 ± 3.3 cm (0.9 ± 0.6 dermatomes) lower than that with the pressure palpator at 25 min. In all instances, the pressure palpator gave a significantly higher assessment than the pinprick. We conclude that the pressure palpator, when preceded by the pinprick test, is associated with an increased threshold. This method may be useful in assessing the sensory block produced by subarachnoid anesthesia. Implications: A novel pressure palpator that maintains the integrity of the epidermis was used to assess the level of sensory block after subarachnoid anesthesia and was compared with the standard method of the pinprick sensation. This method assessed the block consistently higher than the pinprick method, but it may have advantages as a noninvasive sensory test.",
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