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Analysis of increased methemoglobin levels in blood after spinal anesthesia using 2% hyperbaric prilocaine compared to 5% hyperbaric lidocaine in elective urological surgery

  • Willy Kurniawan ,
  • Bambang Pujo Semedi ,
  • Kohar Hari Santoso ,
  • Christrijogo Sumartono ,
  • Prihatma Kriswidyatomo ,
  • Pudji Lestari ,

Abstract

Background: Methemoglobin is an altered state of hemoglobin structure that impairs its ability to transport oxygen. Local anesthesia, especially prilocaine, can induce methemoglobin formation.

Methods: This analytical study employed an experimental single-blind randomized control trial design. A total of 40 subjects aged 18-65 years, with PS ASA I-II, undergoing urological surgery under spinal anesthesia, were included. They were randomly divided into two groups: Group A received hyperbaric lidocaine 5% (75 mg), and Group B received hyperbaric prilocaine 2% (60 mg). Two subjects from each group experienced block failure. Venous blood was drawn from all subjects before, 4 hours, and 8 hours after spinal anesthesia and methemoglobin levels were measured using the ELISA method.

Results: There was no significant difference in methemoglobin levels 4 hours and 8 hours after spinal anesthesia in both groups. The increase in methemoglobin levels 4 hours after spinal anesthesia in the prilocaine group was higher than that of the lidocaine group but not statistically significant. Methemoglobin levels 8 hours after spinal anesthesia began to decrease but remained higher than basal conditions. There were significant differences in methemoglobin levels between basal and 4 hours and between basal and 8 hours in both prilocaine and lidocaine groups.

Conclusions: Blood methemoglobin levels 4 hours and 8 hours after spinal anesthesia with 2% hyperbaric prilocaine were not significantly different from 5% hyperbaric lidocaine. The increase in blood methemoglobin levels 4 hours and 8 hours after spinal anesthesia with 2% hyperbaric prilocaine is not significantly different from 5% hyperbaric lidocaine

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How to Cite

Kurniawan, W., Semedi, B. P., Santoso, K. H., Sumartono, C. ., Kriswidyatomo, P. ., & lestari, P. . (2024). Analysis of increased methemoglobin levels in blood after spinal anesthesia using 2% hyperbaric prilocaine compared to 5% hyperbaric lidocaine in elective urological surgery. Bali Medical Journal, 13(2), 778–784. https://doi.org/10.15562/bmj.v13i2.5134

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Willy Kurniawan
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Bambang Pujo Semedi
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Kohar Hari Santoso
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Christrijogo Sumartono
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Prihatma Kriswidyatomo
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Pudji Lestari
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