scholarly journals SPINAL ANESTHESIA; LOWER SEGMENT CESAREAN SECTION COMPARISON OF ATIENTS WITH HYPERBARIC BUPIVACAINE VERSUS ISOBARIC BUPIVACAINE AS USED FOR SPINAL ANESTHESIA

2016 ◽  
Vol 23 (02) ◽  
pp. 161-165
Author(s):  
Dr. Hamid Raza ◽  
Dr. Bashir Ahmed ◽  
Dr. Kamlaish ◽  
Dr. Saqib Basr ◽  
Dr. Ahmed Ali
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Lower Segment ◽  
Hyperbaric Bupivacaine ◽  
Lower Segment Cesarean Section

scholarly journals SPINAL ANESTHESIA

2016 ◽  
Vol 23 (02) ◽  
pp. 161-165
Author(s):  
Hamid Raza ◽  
Bashir Ahmed ◽  
Kamlaish Kamlaish ◽  
Saqib Basr ◽  
Ahmed Ali
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Blockade ◽  
Lower Segment ◽  
Hemodynamic Changes ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Lower Segment Cesarean Section ◽  
Group A ◽  
Group B

Objective: The purpose of the study is to compare and assess the sensoryand motor block along with the associated hemodynamic changes that occur in the patientpopulation operated for a lower segment cesarean section (LSCS), when they are given 0.5%hyperbaric bupivacaine versus 0.5% isobaric bupivacaine as used for spinal anesthesia.Study Design: Prospective double blind randomized trial. Period: 6 months duration fromApril 2014 to September 2014. Setting: A tertiary care hospital in the city of Karachi, Pakistan.Method: The study population consisted of 60 patients belonging to the ASA 1 and ASA 2category, who underwent a lower segment cesarean section, and comparative analysis ofthe efficacy and associated hemodynamic changes of hyperbaric with isobaric bupivacaine.The patient population was segmented into two groups both groups containing 30 patients,group A receiving hyperbaric bupivacaine 0.5% as 2.5ml ( 12.5mg dose ) and the secondgroup designated as, group B receiving isobaric bupivacaine 0.5% as 2.5ml ( 12.5mg dose)intrathecally. The resultant sensory and motor blockade was determined using pin prick andbromage scale respectively. Results: There was a significant difference found among the twogroups under study, when compared at 3min interval regarding the sensory blockade. The levelof T6 block was reached in 33.33% (n=10) patients belonging to group A and 56.66% (n= 17)patients in group B. It was observed that there was no significant change among the two groupsat 5min interval regarding sensory and motor blockade respectively. The immediate sensoryblockade with isobaric bupivacaine in group B produced greater decrease in the systolic andmean arterial blood pressure when contrasted with hyperbaric bupivacaine in group A at 5mininterval, but after time interval of 45min there was no statistically significant change observed.Conclusions: According to our study the effects of isobaric bupivacaine were more significantlypredictable; hence have a higher efficacy, when contrasted against hyperbaric bupivacainein lower section cesarean section spinal anesthesia. Quick sensory blockade with isobaricbupivacaine was associated with more decrease in blood pressures when contrasted with thehyperbaric bupivacaine, but this result is not statistically significant.

scholarly journals PREVENTION OF SHIVERING DURING LOWER SEGMENT CESAREAN SECTION;

2013 ◽  
Vol 20 (03) ◽  
pp. 409-415
Author(s):  
ASHFAQ AHMED ◽  
MOHAMMAD ASLAM
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Carbon Dioxide Production ◽  
Double Blind Study ◽  
Lower Segment ◽  
Chi Square ◽  
Double Blind ◽  
Lower Segment Cesarean Section ◽  
Group I ◽  
Group Ii

Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for theprevention of shivering caused by spinal anesthesia, during lower segment cesarean section. Main Outcome Measures: Heamodynamicmonitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction. Design: Prospective RandomizedControlled trial. Place: Department of Anesthesia and ICU PNS Shifa Karachi. Duration of study: March 2010 to June 2010. Patients andMethods: 100 ASA-I & II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study,patients were randomly allocated to receive ketamine alone (Group I, n= 50), and ketamine plus midazolam (Group II, n = 50). Afterstandardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes. Results: Shivering was observed in 9/50(18%) patients of group I (Ketamine only) as compared to only 2/50 (4%) patients in Group II (ketamine + midazolam) (p=0.025) whichis statically significant. The two groups were comparable regarding distribution of age (p=0.37), BMI (p=0.27) and duration of surgery.Results were analyzed by using chi square test. Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdosei.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia.

scholarly journals Thoracic spinal anesthesia for cesarean section in severe pre-eclampsia: exploring a new dimension

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Rajeev Chauhan ◽  
Pranshuta Sabharwal ◽  
Rashi Sarna ◽  
Shyamcharan Meena
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Anesthetic Management ◽  
Sensory Block ◽  
Lumbar Region ◽  
Lower Segment ◽  
Hemodynamic Stability ◽  
Emergency Situations ◽  
Lower Segment Cesarean Section ◽  
Thoracic Spinal

Abstract Background Severe pre-eclampsia poses a dilemma for the anesthesiologist especially in emergency situations where cesarean deliveries are done for the un-investigated or partially investigated parturient. Hemodynamic stability is the major goal of anesthetic management of these patients. Thoracic spinal anesthesia has been successfully given for various surgeries like breast cancer and abdominal cancer but not for cesarean section. Case presentation We report a case of a 35-year-old at 33+5-week period of gestation with severe pre-eclampsia and bullous lesions managed successfully with segmental thoracic spinal anesthesia. General anesthesia in this patient could have been risky as the patient was not fasting; airway bullous lesions could not be ruled out and Mallampati grade was III on airway examination. Presence of lesions in lumbar region precluded the lumbar spinal technique. The technique was associated with an adequate level of the sensory block during lower segment cesarean section, a high degree of hemodynamic stability, and a high patient satisfaction Conclusion Segmental thoracic spinal anesthesia can be used successfully and effectively for lower segment cesarean section by experienced anesthetists. Further studies are warranted to compare its effect, especially on hemodynamics with known techniques.

scholarly journals Comparative study of isobaric levobupivacaine and hyperbaric bupivacaine for subarachnoid block in elective cesarean sections

2020 ◽  
Vol 24 (2) ◽  
pp. 215-222
Author(s):  
Dinesh Govinda Rao ◽  
Shalini Anand ◽  
Nayaz Pasha
Keyword(s):  
Cesarean Section ◽  
Sensory Block ◽  
Cesarean Sections ◽  
Cardiovascular Toxicity ◽  
Lower Segment ◽  
Hemodynamic Changes ◽  
Hyperbaric Bupivacaine ◽  
Lower Segment Cesarean Section ◽  
Elective Cesarean ◽  
Sympathetic Blocks

Background & Objective: Hyperbaric bupivacaine 0.5% with fentanyl is often used for spinal anesthesia in lower segment cesarean section (LSCS). Its cardiotoxicity, extended sensory block and high sympathetic blocks in parturients can be disadvantageous. Levobupivacaine, an s-enantiomer of racemic bupivacaine is truly isobaric with CSF. It should be able to produce adequate sensory block with less hemodynamic changes and less cardiovascular toxicity. We aimed to evaluate the clinical efficacy of intrathecal 0.5% isobaric levobupivacaine compared to 0.5% hyperbaric bupivacaine with fentanyl 25 µg for elective LSCS.

scholarly journals A Case of Post-partum Chronic Subdural Hematoma.

2021 ◽  
Author(s):  
Suyasha Rajbhandari ◽  
Pritam Gurung ◽  
Gopi Nepal ◽  
Samir Acharya ◽  
Basant Pant
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Subdural Hematoma ◽  
Dural Puncture ◽  
Post Partum ◽  
Chronic Subdural Hematoma ◽  
Lower Segment ◽  
Post Dural Puncture Headache ◽  
Lower Segment Cesarean Section ◽  
Variable Presentation

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence and has variable presentation. Due to rarity, it may often be misdiagnosed as post-dural puncture headache. In this report, we describe a case of a 25-year-old woman who presented with a headache following lower segment cesarean section after spinal anesthesia.

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