caa a22 4500 445374659 CHVBK 20180317142959.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00540-010-1082-3 doi (NATIONALLICENCE)springer-10.1007/s00540-010-1082-3 The effect of body mass index on the spread of spinal block in patients with rheumatoid arthritis [Elektronische Daten] [Kari Leino, Kristiina Kuusniemi, Heikki Pälve, Hannu Tiusanen, Tapani Tuppurainen] Purpose: Body mass index (BMI) has a significant effect on the spread of sensory spinal block in rheumatoid patients. We tried to achieve the same spread of spinal block for patients in three different BMI groups and, on the basis of the results from a preliminary study, used a simple method feasible for clinical practice. We hypothesized that BMI-related inverse dosing of plain bupivacaine according to low, normal, and high BMI would result in no difference in block extent. Methods: Together 75 patients with seropositive rheumatoid arthritis were included in three equal-sized groups according to BMI: low (<23kg/m2), normal (23-28kg/m2), and high (>28kg/m2). Spinal anesthesia was induced with plain bupivacaine using doses 3.3, 3.0, and 2.7ml, respectively. The spread of sensory block was recorded 30min after injection of bupivacaine by use of a pin-prick test and a cold ice-filled container. Results: Spreads of sensory block were different in low, normal, and high BMI groups (mean (SD); 14.0 (2.6), 14.5 (2.5), and 16.3 (2.5) dermatomes, respectively, P=0.006) because of greater block extent in the high-BMI group. Conclusions: Despite three-step dosing of plain bupivacaine inversely related to BMI (low, normal, or high), comparable block extent was not achieved because of greater spread in the high-BMI group. Adjustment of plain bupivacaine dose according to BMI could be used to achieve a more predictable spread of spinal block, but further reduction of dose is needed in patients with high BMI. Japanese Society of Anesthesiologists, 2010 Body mass index nationallicence Bupivacaine nationallicence Rheumatoid arthritis nationallicence Spinal block nationallicence Leino Kari Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland aut Kuusniemi Kristiina Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland aut Pälve Heikki Finnish Medical Association, Helsinki, Finland aut Tiusanen Hannu Department of Rheumatology, Turku University Hospital, Turku, Finland aut Tuppurainen Tapani Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland aut Journal of Anesthesia Springer Japan 25/2(2011-04-01), 213-218 0913-8668 25:2<213 2011 25 540 https://doi.org/10.1007/s00540-010-1082-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-010-1082-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leino Kari Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland aut NATIONALLICENCE 700 1- Kuusniemi Kristiina Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland aut NATIONALLICENCE 700 1- Pälve Heikki Finnish Medical Association, Helsinki, Finland aut NATIONALLICENCE 700 1- Tiusanen Hannu Department of Rheumatology, Turku University Hospital, Turku, Finland aut NATIONALLICENCE 700 1- Tuppurainen Tapani Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/2(2011-04-01), 213-218 0913-8668 25:2<213 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer