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Compare the Efficacy of Classical Subarachnoid Block Using and Unilateral Spinal Anaesthesia

G. Venkateshwarlu* , G. Venkateshwarlu* , A. Adam** , Fathima***

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Indian Journal of Anesthesia and Analgesia 4(2):p 246-253, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.13

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Abstract

 Aim : To compare the efficacy of classical subarachnoid block using 0.5% bupivacaine (3.5 ml) and unilateral spinal anaesthesia using 0.5% bupivacaine (2ml) in patients undergoing unilateral lower limb surgeries. Materials and Methods: The present prospective study was done for a period of 2 years. 60 cases undergoing unilateral lower limb surgeries were chosen. They were divided into two group 30 patients of control group received 3.5 of 0.5% bupivacaine and turned to supine position immediately. 30 patients of Study group­ received 2ml of 0.5% bupivacaine and kept in lateral decubitus position for 15 minutes and then turned supine. Pre operatively, heart rate, Systolic and diastolic blood pressure were checked and were recorded. Intraoperatively hemodynamic parameters, onset and duration of sensory and motor blockade were recorded every 1 minute until 10 minutes thereafter every five minutes for 30 minutes and thereafter every 15 minutes until 60. Results: The demographic data reveals that both the groups are comparable in age, sex and height ratios. The baseline SBP, DBP, HR were recorded every 1 minute until 10 minutes every 5 minutes until 30 minutes and thereafter every 15 minutes until 60 minutes. Heart rate variation was statistically significant at 7 minutes, 8 minutes, 9 and 10 minutes, with more fall in heart rate in control group than in study group. The SBP was 129.7 +/­ 6.48 at the time of giving spinal anaesthesia showed a gradual fall until 20 minutes and gradually increased to baseline at 60 minutes. P­values are statistically significant at 5 minutes 6 minutes 7 minutes 8 minutes 9 minutes 10 minutes 15 minutes 20 minutes with more fall in blood pressure in control group compared to study group. The fall in diastolic blood pressure observed in control group is statistically significant at 6,7,8,10,15,20,25,30,45,60 minutes. Analysis of motor blockade in the 2 group shows that unilateral spinal block induced lesser degree of motor blockade to the classical subarachnoid block group. This difference was found to be statistically significant. There was no statistically difference in the level of sensory blockade between the groups. There was no statistically difference in the onset time and duration of sensory blockade between the groups. There was statistical difference in duration of motor blockade with longer blockade in both groups. Conclusion: Unilateral low does subarachnoid block offers better hemodynamic stability in the intra­operative period.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.13

Keywords

Unilateral Spinal Anaesthesia; Bupivacaine; Hemodynamic Stability.

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