Background: The aim of this study was to detect if intrathecal hyperbaric Levobupivacaine provided anaesthesia with more stable hemodynamic profile than 0.5% Hyperbaric Bupivacaine for lower limb and abdominal surgery.Methods: This observational study was carried out on 60 Adult patients between 18-65 Years of age, in ASA I and II undergoing lower abdominal surgery. Subarachnoid block using 3.0 ml of 0.5% hyperbaric Levobupivacaine (15 mg) was used as anaesthesia for surgery. Vitals recorded first in operation theatre were taken as baseline and were compared with subsequent readings till closure to judge the fall in blood pressure. Frequencies of parameters falling more than 30% from baseline, amount of IV fluids, vasopressors administered and complications were recorded. The data collected was displayed as mean with a standard deviation and frequency with percentage. Statistical analysis was performed using in stat computer software.Results: On analysis of the data it was found that fall in hemodynamic parameters was significantly lower in the Levobupivacaine group. It was observed that maximum onset of motor block was after 5 minutes, VAS after 4 minutes and loss of pinprick sensation was achieved at T-4 level after 4 minutes. Haemodynamic complications, which required therapeutic interventions, were hypotension (5%), bradycardia (3%), a total of 8%, who required urgent intervention as vasopressors and inotropes.Conclusions: 0.5% Hyperbaric Levobupivacaine, has onset of action similar to other local anaesthetics used for subarachnoid block, but has better hemodynamic profile in comparison to Hyperbaric 0.5% Bupivacaine, the commonly used local anaesthetic agent used for Spinal Anaesthesia.
Background: Target controlled infusion (TCI) is an automated and regulated total intravenous anaesthesia delivering device. On the basis of western pharmacokinetic and pharmacodynamic models it delivers a calculated dosage of intravenous anaesthetic drugs to achieve an ideal anaesthetic plane. The depth of anaesthesia is judged by monitors such as bispectral index (BIS) monitors which gives a rough estimate whether the TCI is delivering more or less.Methods: This analytical study was carried out on 100 patients between 20 to 60 years of age in a teaching hospital. Simultaneous BIS monitoring and TCI were set on these patients. If BIS values went below 45 the target concentration was decreased by 0.5μg/ml and if it was more than Injection propofol was supplemented manually and the changes were collected and analyzed.Results: On analyses and comparison of the data with a western study it was found that the duration of surgery was similar in both studies. With the help of “t” test based on normal distribution it was found that group having BIS <45 and 45-60 were similar in both studies, but the group having BIS >60 was more statistically significant in the Indian population.Conclusions: Depth of anaesthesia was assessed with neurological monitor, BIS, at the time of administration of Target controlled infusion (TCI) and data acquired was compared with data from a western study. The two groups had similar anaesthetic depth levels with the same infusion protocols of Target controlled infusion (TCI).
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