Comparison of haemodynamic changes and level of block during Spinal anaesthesia-Lithotomy v/s Supine position using Ropivacaine and Bupivacaine
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Background and Aims: Spinal anaesthesia is associated with various haemodynamic changes due to sympathetic blockade. Various surgical positions also affects haemodynamics, lithotomy position increases the systolic arterial pressure from the sub extremities with the effect of auto transfusion. Study was designed to compare haemodynamic changes in supine and lithotomy position during spinal anaesthesia, also to compare pharmacological effect and side effect of ropivacaine and bupivacaine in subarachnoid block as secondary outcome variables Material & Methods: Prospective randomized study includes a total of 120 ASA I-II patients who underwent elective haemorrhoidectomy, fissurectomy, TURP and hernia repair. Patients randomly assigned in four groups- Group B (Supine),Group B (Lithotomy), Group R (Supine), and Group R (Lithotomy) based on patients position and type of hyperbaric drug (ropivacaine or bupivacaine) used. Intraoperatively haemodynamic parameters, level of sensory block, onset of motor block, and adverse effects were recorded. Results and conclusion: This study demonstrated that lithotomy position provides more haemodynamic stability as compared to supine position, also concluded that hyperbaric ropivacaine provide less extensive sensory block, which regressed more rapidly & provide more haemodynamic stability as compared to bupivacaine.Background and Aims: Spinal anaesthesia is associated with various haemodynamic changes due to sympathetic blockade. Various surgical positions also affects haemodynamics, lithotomy position increases the systolic arterial pressure from the sub extremities with the effect of auto transfusion. Study was designed to compare haemodynamic changes in supine and lithotomy position during spinal anaesthesia, also to compare pharmacological effect and side effect of ropivacaine and bupivacaine in subarachnoid block as secondary outcome variables Material & Methods: Prospective randomized study includes a total of 120 ASA I-II patients who underwent elective haemorrhoidectomy, fissurectomy, TURP and hernia repair. Patients randomly assigned in four groups- Group B (Supine),Group B (Lithotomy), Group R (Supine), and Group R (Lithotomy) based on patients position and type of hyperbaric drug (ropivacaine or bupivacaine) used. Intraoperatively haemodynamic parameters, level of sensory block, onset of motor block, and adverse effects were recorded. Results and conclusion: This study demonstrated that lithotomy position provides more haemodynamic stability as compared to supine position, also concluded that hyperbaric ropivacaine provide less extensive sensory block, which regressed more rapidly & provide more haemodynamic stability as compared to bupivacaine.
Authors and Affiliations
Dr. Arun Mathur, Dr. Anupama Gupta
Keywords
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- EP ID EP244075
- DOI 10.9790/0853-1610073439
- Views 58
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