Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study
Objective: To assess feasibility, safety, and efficacy of segmental spinal anesthesia with isobaric levobupivacaine in patients undergoing various abdominal and lower limb surgeries. Methods: This was a prospective cohort study conducted at the Department of Anesthesiology and Critical Care of Kot...
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Universitas Padjadjaran
2024-09-01
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| Series: | International Journal of Integrated Health Sciences |
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| Online Access: | https://journal.fk.unpad.ac.id/index.php/ijihs/article/view/3988 |
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| author | Lalit Goyal Saloni Gupta Sachin Nagar Vinay Bhargava |
| author_facet | Lalit Goyal Saloni Gupta Sachin Nagar Vinay Bhargava |
| author_sort | Lalit Goyal |
| collection | DOAJ |
| description | Objective: To assess feasibility, safety, and efficacy of segmental spinal anesthesia with isobaric levobupivacaine in patients undergoing various abdominal and lower limb surgeries.
Methods: This was a prospective cohort study conducted at the Department of Anesthesiology and Critical Care of Kota Heart Institute and group of hospitals in India. The study involved 100 patients undergoing various abdominal and lower limb surgeries under segmental spinal anesthesia (SSA). Isobaric levobupivacaine 0.5% with fentanyl 20-25 μg or dexmedetomidine 5-10 as adjuvant or hypobaric levobupivacaine 0.167% was injected in intervertebral space depending on the surgery. Hemodynamic parameters, postoperative pain level, and adverse effects were analyzed with a p-value less than 0.05 was considered statistically significant.
Results: An overall male predominance was observed with a 1:0.515 male-to-female ratio. The most affected age group was 41-50 years (37%), with a mean age of 44.51 ± 11.72 years. ASA classification indicated 34% of patients in ASA I, 40% in ASA II, 24% ASA III and 2% in ASA IV . The primary surgery was laparoscopic cholecystectomy (26%) in normal risk group and orthopedic in high-risk group(20%). Postoperative pain assessment showed mean VAS scores ranging from 1.92 to 3.42 at different time intervals. Common adverse effects were hemodynamic instability (13%), shoulder tip pain (33%), PONV (3%), headache (6%), pruritis (2%) and urinary retention (1%). The hemodynamic instability showed less incidence in ASA III/IV category.
Conclusion: Segmental spinal anesthesia can be used successfully for abdominal and lower limb orthopedic surgeries in patients of ASA I to ASA IV. |
| format | Article |
| id | doaj-art-55dcbf52366c4ffc8ec62e015c78fb95 |
| institution | OA Journals |
| issn | 2302-1381 2338-4506 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Universitas Padjadjaran |
| record_format | Article |
| series | International Journal of Integrated Health Sciences |
| spelling | doaj-art-55dcbf52366c4ffc8ec62e015c78fb952025-08-20T02:33:07ZengUniversitas PadjadjaranInternational Journal of Integrated Health Sciences2302-13812338-45062024-09-01122879410.15850/ijihs.v12.n2.39881765Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital StudyLalit Goyal0Saloni Gupta1Sachin Nagar2Vinay Bhargava3Anaesthesia and Critical care, Kota Heart Institute and General HospitalAnaesthesia and Critical care, Kota Heart Institute and General HospitalDepartment of Anaesthesia, Critical Care & Pain, Aarvy Healthcare Super Speciality Hospital, Kalyani Hospital GurugramAnaesthesia and Critical care, Kota Heart Institute and General HospitalObjective: To assess feasibility, safety, and efficacy of segmental spinal anesthesia with isobaric levobupivacaine in patients undergoing various abdominal and lower limb surgeries. Methods: This was a prospective cohort study conducted at the Department of Anesthesiology and Critical Care of Kota Heart Institute and group of hospitals in India. The study involved 100 patients undergoing various abdominal and lower limb surgeries under segmental spinal anesthesia (SSA). Isobaric levobupivacaine 0.5% with fentanyl 20-25 μg or dexmedetomidine 5-10 as adjuvant or hypobaric levobupivacaine 0.167% was injected in intervertebral space depending on the surgery. Hemodynamic parameters, postoperative pain level, and adverse effects were analyzed with a p-value less than 0.05 was considered statistically significant. Results: An overall male predominance was observed with a 1:0.515 male-to-female ratio. The most affected age group was 41-50 years (37%), with a mean age of 44.51 ± 11.72 years. ASA classification indicated 34% of patients in ASA I, 40% in ASA II, 24% ASA III and 2% in ASA IV . The primary surgery was laparoscopic cholecystectomy (26%) in normal risk group and orthopedic in high-risk group(20%). Postoperative pain assessment showed mean VAS scores ranging from 1.92 to 3.42 at different time intervals. Common adverse effects were hemodynamic instability (13%), shoulder tip pain (33%), PONV (3%), headache (6%), pruritis (2%) and urinary retention (1%). The hemodynamic instability showed less incidence in ASA III/IV category. Conclusion: Segmental spinal anesthesia can be used successfully for abdominal and lower limb orthopedic surgeries in patients of ASA I to ASA IV.https://journal.fk.unpad.ac.id/index.php/ijihs/article/view/3988asa grade, levobupivacaine, segmental spinal anesthesia, visual analogue scale |
| spellingShingle | Lalit Goyal Saloni Gupta Sachin Nagar Vinay Bhargava Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study International Journal of Integrated Health Sciences asa grade, levobupivacaine, segmental spinal anesthesia, visual analogue scale |
| title | Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study |
| title_full | Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study |
| title_fullStr | Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study |
| title_full_unstemmed | Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study |
| title_short | Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study |
| title_sort | feasibility safety and efficacy of segmental spinal anesthesia with predominantly isobaric levobupivacaine a tertiary care hospital study |
| topic | asa grade, levobupivacaine, segmental spinal anesthesia, visual analogue scale |
| url | https://journal.fk.unpad.ac.id/index.php/ijihs/article/view/3988 |
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