Injected Substances
Bupivacaine (Marcaine) is the local anaesthetic most commonly used, although lignocaine (lidocaine), tetracaine, procaine, ropivacaine, levobupivicaine and cinchocaine may also be used. Sometimes a vasoconstrictor such as epinephrine is added to the local anaesthetic to prolong its duration. Of late, many anaesthesiologists are preferring to add opioids like morphine, fentanyl, or buprenorphine, or non-opioids like clonidine, to the local anaesthetic used in a spinal injection, to give a smoother effect and to provide prolonged pain relief once the action of the spinal local anaesthetic has worn off.
Baricity refers to the density of a substance compared to the density of human cerebral spinal fluid. Baricity is used in anaesthesia to determine the manner in which a particular drug will spread in the intrathecal space. Usually, the hyperbaric, (for example, hyperbaric bupivacaine) is chosen, as its spread can be effectively and predictably controlled by the anaesthesiologist, by tilting the patient. Hyperbaric solutions are made more dense by adding dextrose to the mixture.
Read more about this topic: Spinal Anaesthesia
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