scholarly journals COMPARISON BETWEEN UNILATERAL SPINAL ANESTHESIA AND CONVENTIONAL SPINAL ANESTHESIA IN ORTHOPEDIC LOWER LIMB OPERATION FOR HEMODYNAMIC STABILITY

2020 ◽  
Vol 10 (1) ◽  
pp. 81-87
Author(s):  
Amir Murad khudadad ◽  
◽  
Bwar Ali Hussein ◽  
Keyword(s):  
Spinal Anesthesia ◽  
Lower Limb ◽  
Hemodynamic Stability ◽  
Unilateral Spinal Anesthesia

scholarly journals Evaluation of bupivacaine-clonidine combination for unilateral spinal anesthesia in lower limb below-knee orthopedic surgery

2014 ◽  
Vol 8 (3) ◽  
pp. 384 ◽  
Author(s):  
Manisha Sapate ◽  
Preety Sahu ◽  
Bhavini Shah ◽  
Chhaya Suryawanshi ◽  
Anitha Kulkarni ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Unilateral Spinal Anesthesia

scholarly journals Comparison of Efficacy of Different Doses of Clonidine with 0.5% Bupivacaine for Spinal Anesthesia in Lower Limb Orthopedic Surgeries

2017 ◽  
Vol 3 (2) ◽  
pp. 45-49
Author(s):  
KT Venkatesh Murthy ◽  
Maya D Nadkarni ◽  
N Amaranath
Keyword(s):  
Postoperative Complications ◽  
Spinal Anesthesia ◽  
Lower Limb ◽  
Saline Group ◽  
Controlled Study ◽  
Hyperbaric Bupivacaine ◽  
Hemodynamic Stability ◽  
Group Iii ◽  
Group I ◽  
Different Doses

ABSTRACT Clonidine, a centrally acting α2 adrenergic agonist has been under use as an adjuvant with hyperbaric bupivacaine for prolonging analgesia and maintaining hemodynamic stability during lower limb orthopedic and lower abdominal surgeries. The purpose of our study was to compare the efficacy and safety of intrathecal Clonidine 50 and 75 μg as adjuvant to hyperbaric Bupivacaine 15 mg (3 mL), and hyperbaric Bupivacaine 3 mL with saline 0.5 mL for onset and duration of anesthesia, hemodynamic stability, and side effects if any. This prospective randomized controlled study was conducted on 120 patients scheduled for lower limb orthopedic surgeries under spinal anesthesia. The study population was divided into three groups with 40 patients in each group. Group I (controlled group) received 3 mL (15 mg) of 0.5% Bupivacaine heavy and 0.5 mL of normal saline. Group II received 50 μg of clonidine followed by Bupivacaine 0.5% 3 mL (15 mg) and group III received 75 μg of clonidine followed by Bupivacaine 0.5% 3 mL (15 mg) intrathecally. Time taken for onset of sensory and motor blockade, duration of anesthesia, and any perioperative and postoperative complications was noted. We found that clonidine 75 μg given prior to bupivacaine, 3 mL, significantly prolongs the duration of anesthesia with minimal changes in hemodynamic parameters and postoperative complications. How to cite this article Murthy KTV, Nadkarni MD, Amaranath N. Comparison of Efficacy of Different Doses of Clonidine with 0.5% Bupivacaine for Spinal Anesthesia in Lower Limb Orthopedic Surgeries. J Med Sci 2017;3(2):45-49.

scholarly journals Haemodynamic Effects and Complications of Unilateral Spinal versus Standard Spinal Anesthesia in Elderly with Low Ejection Fraction Undergone Lower-Limb Surgery

2017 ◽  
Vol 5 (1) ◽  
pp. 20-24
Author(s):  
Md Mushfiqur Rahman ◽  
Md Mahbubul Hasan Munir ◽  
Raihanuddin ◽  
Shafiul Alam Shaheen ◽  
Md Abdus Salam Khan ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Sympathetic Block ◽  
Hyperbaric Bupivacaine ◽  
Unilateral Spinal Anesthesia ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B

Background: Cardiovascular system may be profoundly affected by spinal anaesthesia due to unavoidable sympathetic blockade which is more prominent in elderly.A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes.Objective: To assess whether a unilateral spinal anaesthesia using 0.5% hyperbaric bupivacaine will restrict the sympathetic block to avoid the undesired cardio vascular effects.Materials and method: In this prospective study 60 ASA Ill and IV patients aged between 60-90 years undergoing unilateral lower limb surgery were included. Patients were divided into two groups. In group-A, dural puncture was performed with the patient in the lateral decubitus position with 1.5 mL of hyperbaric bupivacaine. In group-B, it was performed with the patient in a seated position using 1.5 mL hyperbaric bupivacaine. Each patient was then placed in supine position. The speed of injection was 1 mL/30s. Patients were placed in the lateral position with operated side down and kept in this position for 10 minutes. Motor and sensory levels were assessed, and haemodynamic alterations were monitored just after block, 5, 10, 15 and 30 minutes of spinal anaesthesia.Results: The demographic data were found similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group-B. The duration of motor and sensory block was significantly shorter in group-A. Haemodynamically all the parameters revealed better out come in unilateral spinal anesthesia. The incidence of complications (nausea, headache, and hypotension) was also lower in group A.Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during surgery on a lower limb. Furthermore, this technique avoids unnecessary paralysis on the non-operated side.Delta Med Col J. Jan 2017 5(1): 20-24

scholarly journals Comparison of Various Techniques of Anesthesia for Surgical Management of Diabetic Foot

2020 ◽  
Vol 5 (2) ◽  
pp. 62-65
Author(s):  
Kapil S. Divekar ◽  
Karishma D. Mehta ◽  
Pancham Mehta ◽  
Payal P. Prajapati ◽  
Kamla H. Mehta
Keyword(s):  
Side Effects ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Surgical Management ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Diabetic Foot ◽  
Hemodynamic Stability ◽  
Unilateral Spinal Anesthesia ◽  
Group A

Background: Diabetes mellitus is a multisystem disease caused by an absolute or relative deficiency of insulin secretion or resistance or a combination of both. Anesthesia in them is of special concern because of complex polypharmacy, an inappropriate dose of oral hypoglycemic agents or insulin and errors in converting IV insulin to usual medication. The objective is to compare the various techniques of anesthesia for surgical management of diabetic foot in terms of intraoperative hemodynamic stability, perioperative problems related to anesthesia techniques, postoperative analgesia. Subjects and Methods: Sixty adult diabetic patients of both gender of ASA grade II-III, aged 35years undergoing surgical management of diabetic foot were elected and separated into three groups, Group A: general anesthesia with tracheal intubation, Group B: unilateral spinal anesthesia with injection 0.5% bupivacaine heavy 1.5ml (7.5mg), Group C: popliteal nerve block via lateral approach by injecting 30 ml 0.5% bupivacaine. Parameters like pulse rate, mean arterial blood pressure, respiratory rate and SpO2 were recorded at regular intervals. Postoperative pain, perioperative side effects, complications and problems related to anesthetic techniques were noted. The analysis is done by unpaired t-test and chi-square test. Results: Group C patients were hemodynamic stable than Group A and B. Post-op analgesia was prolonged in Group C. Perioperative side effects were more found in Group A. Conclusion: Popliteal nerve block and unilateral spinal anesthesia provide better hemodynamic stability and postoperative analgesia with negligible side effects as compared to general anesthesia for surgical management of diabetic foot.

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