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Analysis Study Research Paper | Anaesthesiology | India | Volume 12 Issue 3, March 2023 | Rating: 4.9 / 10
A Study on Outcome of Combined Spinal Epidural Anaesthesia in Patients Undergoing Lower Limb Orthopaedic Surgeries in a Rural Tertiary Care Hospital
Karanam Sandhya | Kandula Renuka | Pyarejan Basheer
Abstract: Aim: To evaluate the complications and postoperative analgesia with combined spinal - epidural in patients undergoing lower limb orthopedic surgeries. Methods and materials: The study was conducted in 90 patients in age group of 18 ? 80 years of ASA 1 and 2 scheduled for lower limb orthopedic surgeries. The double - space combined spinal epidural technique was performed using 2 - 2.5 ml 0.5% H bupivacaine and an additive and after five minutes, a 10 ml 0.25% Bupivacaine solution with 25 - 50 mcg Fentanyl was given epidurally. Onset and level of sensory blockade, duration of analgesia, quality of analgesia using visual analogue scale (VAS), vital parameters were recorded at 0, 5 minutes (min) then at regular intervals. Postoperative analgesia with epidural infusion of 0.125% Bupivacaine with 1mcg/ml fentanyl [at] 5ml/hr for 20 hours. Quality of post - operative analgesia (VAS), BP & HR, need for rescue analgesia were monitored post operatively. Results: Maximum patients attained T8 level (58.9%). The mean duration to achieve grade IV motor blockade was 8.83 ? 1.21 min, the mean duration of analgesia is 10+ 2.6hr. This VAS score is almost less than 2 in all patients in the first 4 - 6 hours, 40% of patients needed rescue analgesia after 10 hours. No significant changes in hemodynamic parameters. Conclusion: The CSE technique is an easy method to provide adequate analgesia with stable hemodynamics and less side effects.
Keywords: combined spinal epidural, orthopedic surgeries, rescue analgesia, VAS
Edition: Volume 12 Issue 3, March 2023,
Pages: 572 - 574