Abstract
Background: LSAB (Lumbar subarachnoid blockade) is being used as a standard methodology for LSCS patients. Spinal Anesthesia is being associated with a profound advantage compared to general anaesthesia in obstetric patients. This anaesthetic method with definitive end points is administered before the pfannesfeil or vertical incision as the case may be. After the provision of the surgical anesthesia, the analgesic effect of LSAB is continued in to the postoperative period for some time. Thereby it provides premptive analgesia, which can be continued into the entire postoperative period, by use of NSAIDS or opiods
Materials and Method: In this study 50 patients posted for lower segment caesareans section on elective or emergency basis are selected fitting into the study after assigning into the exclusion and inclusion criteria. After the administration of spinal Anesthesia for the patients, then level of blockade confirmed using the spirited cotton. After surgery is over, the time of administration of the rescue analgesia in ers in the form of morphine hydrochloride is noted. Thereby it is noted that the LSAB administered before the surgery serves as an analgesic too in the postoperative period. This means that the LSAB serves as a premptive analgesic.
Results: It was found that in post LSCS patients the analgesic effect of LSAB lasts for 70 minutes. There by we can extend the preemptive analgesia by the administration of various agents in the form of diclofenac suppository or opioids or Ketanov or ilioinguinal or iliohypogastric blocks etc.
Conclusion: By the administration of the analgesics, early mobilization of the mother increases maternal bonding with child, increased breast feeding and prevents hypoglycemic complications in the newborn.
Keywords: VAS –Visual analogue scale LSCS- Lower segment caesarian section, LSAB-lumbar subarachnoid blockade.
References
- Gibbs cp krischer j, peckham BM, sharp H, Kirschbaum TH, Obstetric anaesthesia-A national survey Anaesthesiology 1986 : 65, 298-306.
- Dudziak R, Uihlein Uihlein M, Loslichkeit Von local anaesthetia 1 m liquor cerebrospinalis and ihre uhhangigkit Vonder was serstoffi one konzentration Regional Anaesthesic 1978: 1:32-37
- Biscoping j, E influss der glucose koncntration von bupi vacain losuing asfdie local anaesthesia vertenilung in liquor bei spinal anaesthesia Regional Anaesthesic 1986: 9: 9-14.
- Dennhar dt R, Konder H, Blut-und liquorspiegal von bupivacain beispinal anaesthesia Regional Anaesthesie 1983, 6: 72-75
- Meyer j, Nolte H, Liqourkon contration von bupicain nachsubdurates application Regional Anaesthesic 1978 : 38-40.
- The journal of spinal anaesthesic today. Annals Chirugae of Gynaecologiae 1984: 73: 131-38
- Carrie LES, O Sullivan G. Subarachnoid bupivacaine 0.5% for caserian section . European journal of Anaesthesia 1984 : 1: 275-283.
- Russell IF spinal Anaesthesia for caesrian section British journal of Anaesthesia 1983,55:309-314.
- Sprague DH. Effect of position and uterine displacement on spinal Anaesthesia for caeserian section Anaesthesiology 1979: 44:164-166.
- Morgan M.Obstetric Anaesthesia and analgesia In : Nimmo WS, Smith G, eds Anaesthesia Oxford : Blackwell scientific publication, 1979: 707
- Gori F, Corradetti F, Ceratfo V, peduto VA, Influence of positioning on plain bupivacaine spinal Anaesthesiol Res pract 2010: 2010:1-4
- Luci AC polis TZ, Cicetti NJ,Densities of CSF and spinal Anaesthetic solution in surgeical patients at body temperature can J Anaesth 1998,45:297-303.
- F Lanagan HL, Daffa S Lamierof DH, Grissen AJ, covino BG, Effect of pregnancy on bupivacaine induced conduction blockade in the isolated rabbit vagus nerve Anaesth Analg 1987: 66:L 123-6
- Gaiser R, physiological changes of pregnancy. In chestnut DH, Wng CA, Tsen LC, nNgankee WD, Beilin Y, Mhyre Jm, et al editors Chest nut, Obstetric Anaesthesie principles and practice 5TH Philadeplhia : Elsevier saunder: 2014.p15-38.
- Shah S, Nathan L, Singh R, Fuys, Chaudhari G. E2 and not p4 increases nitric oxide release from NANC nerve of the GIT implication in pregnancy, Am J physiol Regal Integr Comp physioal 2001 : R 1546-54
- Carter J Liver Function in normal pregnancy.Aust NZJ Obstetric gynacol 1990:30:296-302.
Corresponding Author
Dr C. Jayakumar
Associate Professor, Department of Anesthesiology, Government Medical College, Trivandrum, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.63
