Cold and Touch Stimulation For The Assessment of Block Level At Spinal Anesthesia

Objective: To determine the dermatomal level of sensory block after spinal anesthesia traditionally used method is pinprick test. Pinprick test is an invasive and painful method. We aimed to compare the dermatomal levels of sensory block determined by noninvasive simple tests touch and cold sense loss with routinely used invasive pinprick stimulation test in clinical practice. Materials and Methods: Spinal anesthesia was performed with the patients placed in the sitting position by injecting 1 mg kg-1 2 % lidocaine intrathecally through a 22 gauge needle inserted at the L3-4 interspace. Spinal anesthesia was performed with the patients 1 2 % lidocaineplaced in the sitting position by injecting 1 mg kg intrathecally through a 22 gauge needle inserted at the L3-4 interspace. The levels of block were assessed at 5th and 20th min after the spinal injection. Needle for pinprick, a piece of cotton for touch and ice in a finger of surgical glove for cold sensory were used. Results: No significant difference was observed between the dermatomal level of loss of pinprick sense and the dermatomal level of loss of either touch sense or cold sense at 5th min. However at 20th min the dermatomal level of loss of touch sense was significantly lower than the dermatomal level of loss of pinprick and cold sensations (p<0.05). Conclusion: It may be beneficial to use the non-invasive method touch stimulation instead of pinprick test for the assessment of block level at spinal anesthesia. ©2007, Firat University, Medical Faculty