Effects of Combined Spinal Epidural Anaesthesia and Spinal Anaesthesia on Peri-Operative Pulmonary Status in Geriatric Patients in Lower Extremity Surgery

Begum, Sharmin; Akhtaruzzaman, Akm; Bhowmick, Dilip Kumar; Banik, Debabrata; Mh, Rahman; Rahman, A. K. M. Shahidur; Rahman, Md. Saydur; Hasan, Khandoker Moynul; Ahsan, Mohammad Kamrul; Islam, Md. Imrul; Arefin, Muhammad Shamsul; Islam, Tahmidul

doi:10.4236/jbm.2020.810012

Cited by 1 publication

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References 22 publications

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“…Therefore, the SA group showed a faster onset of sensory block. Begum et al [ 11 ] observed that the mean (±SD) duration of anesthesia was significantly longer in the SCSEA group than in the SA group (256.57 ± 33.56 minutes versus 214.71 ± 18.03 minutes, P < 0.001), and the mean (±SD) time to achieve a target level of sensory block was significantly longer in the SCSEA group than in the SA group (11.21 ± 2.2 minutes versus 3.5 ± 1.5 minutes, P < 0.001) [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A Study of the Clinical Effects of Sequential Combined Spinal Epidural Anesthesia and Spinal Anesthesia in Patients Undergoing Orthopedic Surgeries

LN,

Madhusudhana

2023

Cureus

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Background: In orthopedic surgeries, there has been an increase in the usage of the neuraxial blockade to provide excellent surgical conditions and prolonged postoperative analgesia. The introduction of the sequential combined spinal epidural anesthesia (SCSEA) technique provides benefits for both spinal anesthesia (SA) and epidural anesthesia. The focus of this study was to analyze the time needed to attain a desired level of sensory block, to compare the period of sensory block, and to study the intraoperative hemodynamics in the SCSEA and SA groups. Materials and methods: The study was conducted on patients admitted for elective lower limb orthopedic surgeries. The sample size for this prospective randomized study is two groups of 67 subjects each. Patients aged between 18 and 65 years, posted for orthopedic surgeries for two to three hours, and of American Society of Anaesthesiologists (ASA) Grades 1 and 2 were included and divided into two groups. Group A patients received SCSEA with an epidural-test dose of 3 ml lignocaine (2%) with adrenaline and spinal bupivacaine (0.5%) of 1.5 ml-7.5 mg + fentanyl .25 mic if the sensory level was below T8. An epidural top-up was given with 2 ml per segment of 0.5% bupivacaine to bring the sensory level to T8. Group B patients received SA with spinal bupivacaine (0.5%) of 3 ml-15 mg + fentanyl .25 mic. Intraoperative hemodynamics, the duration to achieve a sensory level of T8, the time for two-segment regression of sensory block, and the complications that occurred were recorded. Results: The study included a total of 134 subjects with each group having 67 subjects admitted for lower limb surgery. The mean value (SD) of the time taken to attain sensory block in the SCSEA group was prolonged when compared to the SA group (7.15 ± 0.75 and 5.01 ± 0.88). The time for two-segment regression in the SCSEA group was 86.77 ± 3.60 and the SA group was 106.4 ± 8.01, which indicated that the SA group has a longer and better sensory block. Substantially, the study shows that the SCSEA group (P < 0.05) has better hemodynamics when compared to the SA group. Conclusion: The SCSEA technique has better intraoperative hemodynamic stability with a longer analgesic effect when compared to SA. SA shows a sudden change in hemodynamics but reveals a greater sensory block.

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Section: Discussionmentioning

confidence: 99%