Comparison of Effect and Complication of Unilateral Spinal Anesthesia versus Standard Spinal Anesthesia in Orthopedic Surgery of Lower Limb

Document Type : Research Paper

Authors

1 Associate professor of Anesthesiology, Mashhad Universitiy of Medical Sciences, Mashhad, Iran

2 Assistant professor of Anesthesiology, Mashhad Universitiy of Medical Sciences, Mashhad, Iran

3 Resident of Anesthesiology, Mashhad Universitiy of Medical Sciences, Mashhad, Iran

Abstract

Introduction
Restricted sympathetic block during spinal anesthesia may minimize hemodynamic change. This prospective randomized study compared unilateral and bilateral spinal anesthesia with respect to intra and postoperative advantage and complication of each technique.
Materials and Methods
Spinal anesthesia with 0.5% hyperbaric bupivacaine and 25G Quincke needle was induced in two group of patients with physical status ASA I-II admitted to orthopedic surgeries. In group A dural puncture was performed with the patient in sitting position with 2.5cc hyperbaric bupivacaine and then in supine positon. In group B dural puncture was performed with the patient in lateral decubitus position with 1.5cc hyperbaric bupivacaine with the line operated down ward .The speed of injection was at 1ml/30s. duration of lateral decubitus positon was twenty minutes.
Results
Demographical data were similar. The onset time of sensory and motor block was significantly shorter in group A (p=0.00). Duration of motor and sensory block was shorter in group B (p< 5%). The success rate of unilateral spinal anesthesia in group B was 94.45%. Two patient's spinal block Spread to the nondependent side. The incidence of complication (Nusea, headache, hypotension) was lower in group B. (p=0.02).
Conclusion
Unilateral spinal anesthesia with low dose, low volume and low flow injection technique provides adequate sensory and motor block and stable hemodynamic parameters in orthopedic surgery of lower limb. Patients Satisfacation also was better and avoids unnecessary paralysis on the non operated side

Keywords

medical journal of mashhad university of medical sciences
Volume 55, Issue 4 - Serial Number 4
January and February 2013
Pages 231-236

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