Continuous spinal anaesthesia and analgesia in high-risk patients undergoing abdominal surgery
Indian Journal of Surgery, cilt.68, sa.2, ss.73-79, 2006 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 68 Sayı: 2
- Basım Tarihi: 2006
- Dergi Adı: Indian Journal of Surgery
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.73-79
- Anahtar Kelimeler: Anaesthetic technique, Analgesia, Continuous spinal anaesthesia, High-risk, Humans, Patients, Postoperative
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Background: Continuous spinal anaesthesia has been used as a possibly safer technique than general anesthesia alone, in high-risk patients with a more predictable effect and lesser hemodynamic and respiratory repercussions. Aim: To evaluate the consequences of continuous spinal anaesthesia and analgesia, in 52 high-risk patients undergoing major abdominal surgery. Settings and Design: Operating room and postanaesthesia care unit of an oncology hospital; a prospective study. Materials and Methods: After inserting the 22 gauge spinal catheter, plain 0.5% Bupivacaine 7.5 mg was administered through the catheter. Additional doses of Bupivacaine 2.5 mg were given, until a sensory T4 level and total dose was noted. The postoperative analgesia involved a continuous intrathecal infusion of Sufentanil 1 mg h-1 with Bupivacaine 1 mg h-1. Pain scores and side effects were assessed at 1, 2, 4, 6, 12, 18 and 24 h after the surgery. Results: The dose of Bupivacaine required to achieve the sensory T4 level, was 13.1±4.5 mg. Forty percent of patients had hypotension and were easily controlled by the intermittent intravenous bolus of Ephedrine (22.2±16.8 mg). The technique provided effective analgesia with low dynamic and static pain scores and a low incidence of minor side effects such as nausea (14%), vomiting (6%) and pruritis (22%). Statistical Analysis: Kolmogorov Smirnov test was used to analyze the distribution of the data. Data are presented as mean ± SD, median, range or percentages. Conclusions: We concluded that continuous spinal anaesthesia and analgesia for the perioperative management could be performed effectively and safely, in high-risk patients with minimal adverse effects.