BACKGROUNDIn spinal anaesthesia, commonly used drugs are isobaric bupivacaine and hyperbaric bupivacaine. Commonly opioids like fentanyl are used as adjuvants with local anaesthetics to improve analgesic intensity and to achieve faster onset and prolonged duration. This study aims at comparing isobaric bupivacaine-fentanyl and hyperbaric bupivacaine-fentanyl primarily, in terms of onset and duration of sensory and motor blockade and secondarily, in terms of haemodynamic changes and associated complications.
MATERIALS AND METHODSEighty patients belonging to American Society of Anaesthesiologists I and II undergoing infraumbilical surgeries under spinal anaesthesia were randomised into two groups. Group A received 3 ml of 0.5% isobaric bupivacaine with 25 micrograms fentanyl, while Group B received 3 ml of 0.5% hyperbaric bupivacaine with 25 micrograms fentanyl. Student's unpaired t-test and the χ2 test were used to analyse the results, using the SPSS version 11.5 software.
RESULTSThe mean onset of sensory block was significantly faster in Group B (3.55 ± 0.96 min) than in Group A (5.70 ± 0.69 min). The mean duration of sensory block was significantly longer in Group B (189.65 ± 9.58 min) than in Group A (129.08 ± 3.47 min). The mean onset of motor block was significantly faster in Group B (4.78 ± 0.80 min) than in Group A (7.83 ± 0.78 min). The mean duration of motor block was significantly longer in Group B (204.55 ± 12.46 min) than in Group A (171.18 ± 4.31 min). Isobaric bupivacaine-fentanyl mixture was associated with better haemodynamic stability as compared with hyperbaric bupivacaine-fentanyl mixture.
CONCLUSIONIntrathecal isobaric bupivacaine-fentanyl mixture is associated with lesser duration of both sensory and motor blockade, thereby enabling quicker recovery from anaesthesia and also better haemodynamic stability as compared with hyperbaric bupivacaine fentanyl mixture for infraumbilical surgeries.HOW TO CITE THIS ARTICLE: Sajjan AV, Yenni S, Sanikop CS. Comparison of onset and duration of sensory and motor blockade between intrathecal 0.5% isobaric bupivacaine with 25 micrograms fentanyl and 0.5% hyperbaric bupivacaine with 25 micrograms fentanyl for infraumbilical surgeries-a one-year hospital based randomised controlled trial.
BACKGROUND Unilateral spinal anaesthesia is a promising alternative to traditional, widely used techniques of central neuraxial blocks. Present study was taken up to assess haemodynamic effects, level achieved and duration of block with low dose 0.7 mL (3.5 mg) of 0.5% hyperbaric Bupivacaine.
MATERIALS AND METHODSThis is a one year hospital-based cross-sectional study on a total of 100 patients undergoing unilateral lower limb surgery under unilateral spinal anaesthesia. 0.7 mL (3.5 mg) of 0.5% bupivacaine heavy was injected with patient in lateral position at L3-4 space with the limb to be operated on the dependent side. Patients were maintained in lateral position for 20 minutes and then made supine. Haemodynamic parameters SBP, DBP, MBP and HR were recorded. Sensory and motor block was evaluated.
RESULTSIn this study out of 100, 72 were males. Mean age was 47.79 ± 13.91 years and mean weight was 57.90 ± 8.56 kgs. SBP, DBP and MBP decreased with maximum fall noted at 40 minutes and gradually increased, subsequently reaching the baseline levels at 90 minutes. Maximum increase in HR was seen at 40 minutes after giving spinal and it gradually reduced coming to baseline levels at 90 minutes. Maximum sensory level of L1 was achieved. The block remained unilateral in all the cases. Motor blockade was adequate in the limb to be operated.
CONCLUSIONSubarachnoid block with 0.7 mL (3.5 mg) of 0.5% hyperbaric bupivacaine used in this study does not produce any adverse haemodynamic changes and lasts for short duration that is 90 minutes and can be used in surgeries of shorter duration.
KEY WORDSVery Low Dose Hyperbaric Bupivacaine; Unilateral Spinal Anaesthesia. HOW TO CITE THIS ARTICLE: Shreedevi Y, Vandana G, Sanikop CS. Haemodynamic effects of unilateral spinal anaesthesia with low dose of 0.5% hyperbaric bupivacaine-a clinical study. BACKGROUNDSpinal anaesthesia is commonly used in anaesthetic practice, although the undesirable sequels related to this technique are well known. In the majority of cases spinal anaesthesia is accompanied by a decrease in arterial pressure; bradycardia, due to blockage of preganglionic sympathetic fibres. The incidence of hypotension depends upon number of factors such as the extent of subarachnoid blockage, age, associated coexisting disorders, presence of medication like ßadrenergic receptor blockers etc. 1,2 Moreover, the sympathetic blockage is often accompanied by uncontrolled hypothermia, especially at low environmental temperature. 3 Unilateral spinal anaesthesia is a promising alternative to traditional, widely used techniques of central neuraxial blocks as it restricts markedly the anaesthetised area, thereby decreasing the risk of adverse events and complications.
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