Title: Comparative Evaluation of Classical Subarachnoid Block, Unilateral Subarachnoid Block and Low Dose Subarachnoid Block with Fentanyl in ASA III and ASA IV Patients Undergoing Lower Limb Surgeries
Authors: Dr Alladi Srikanth, Dr Pradeep Samuel Indurkar, Dr Manda H, Nagrale
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.67
Spinal anaesthesia is considered as a safe technique but can be detrimental to patients with hemodynamic instability. Safety improves if the block can be localized to the area of surgery. Patients with ASA3 and ASA4 grades are haemodynamically unstable. Hence an effective alternative may be unilateral subarachnoid block for lower extremity surgeries. Aim-to compare classical subarachnoid block(SAB) with unilateral SAB and low dose SAB. Method- 60 patients were divided in three groups. Control Group received 2ml of 0.5% Bupivacaine and turned to supine position immediately. STUDY Group I received 2ml of 0.5 % Bupivacaine and kept in lateral position for 10 minutes and then turned supine. STUDY Group II received 1.5 ml of 0.5 % Bupivacaine with 25 µg( 0.5 ml) Fentanyl and kept in lateral position for 10 minutes and then turned supine. Sensory blockade, motor blockade and haemodynamic parameters were studied. Results- Bradycardia and hypotension requiring treatment was less in both study groups. Unilateral spinal block and low dose spinal block induced lesser degree of motor blockade. There was no statistical difference in the onset time and duration of sensory and motor blockade among the 3 groups. Conclusion- we conclude that in high risk patients undergoing unilateral lower limb surgeries Unilateral low dose subarachnoid block offers better hemodynamic stability during the intra-operative period without affecting the quality of sensory and motor blockade Key words- Sabarachnoid block, unilateral block, low dose spinal, Bupivaicain.
Abstract
