Cerebrospinal Fluid and Spinal Anesthesia Parameters in Healthy Versus Opium-Addict Patients during Lower Limb Surgery

Abstract

Background: Studies have reported lower pain threshold, spinal anesthesia duration, and level of sensoryblock in addicts compared to non-addict patients undergoing spinal anesthesia for surgery. Moreover, bloodgas and cerebrospinal fluid (CSF) were likely to be affected as well. The aim in the present study is to evaluateCSF and spinal parameters in addict versus non-addict patients during lower limb surgery.Methods: In this case-control study, 22 opium addicts and 22 sex- and age- matched non-addicts undergoinglower limb surgery under spinal anesthesia were included. The CSF parameters, venous blood gas (VBG), andsensory and motor block findings were compared between the groups.Findings: The addict and non-addict patients were similar regarding CSF and blood gas parameters excepthigher pH in VBG (7.39 ± 0.06 vs. 7.33 ± 0.11, P = 0.030) and CSF (7.39 ± 0.06 vs. 7.33 ± 0.11, P = 0.030) foraddict patients. The addict patients had significantly later onset of sensory block (5.72 ± 1.57 vs. 3.16 ± 0.93minutes, P < 0.001) and shorter motor block duration (137.72 ± 11.51 vs. 149.09 ± 14.44 minutes, P = 0.006),with no significant difference in the sensory block duration and motor block onset.Conclusion: Addict patients have delayed onset of sensory block with shorter duration of motor block and lowersensory block level. Among the blood gas and CSF markers, only pH was significantly higher in addict patients,needing further evaluations; however, it seems that addiction has no significant effect on these parameters.

Keywords

• opioid-related disorders
• anesthesia, spinal
• opium
• bupivacaine
• cerebrospinal fluid