scholarly journals Combined Spinal Epidural Overcoming a Lumbar Lipoma for Lower Limb Both Bone Fracture

2021 ◽  
Vol 6 (2) ◽  
pp. 44-45
Author(s):  
Robin S Chacko ◽  
Krishna Prasad Thangarasu ◽  
Hariesh Annamalai
Keyword(s):  
Bone Fracture ◽  
Lower Limb ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

Effect of Adding Magnesium Sulphate to Epidural Bupivacaine Compared to Addition of Fentanyl in Patients undergoing Lower Limb Orthopedic Surgery under Combined Spinal Epidural Anathesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ibrahim El-Desoukey Mohamed ◽  
Sahar Mohammed Kamal Mahmoud ◽  
Kareem Youssef Kamal
Keyword(s):  
Orthopedic Surgery ◽  
Magnesium Sulphate ◽  
Lower Limb ◽  
The Other ◽  
Sulphate Group ◽  
Sensory Blockade ◽  
Combined Spinal Epidural ◽  
Epidural Bupivacaine ◽  
Spinal Epidural ◽  
Fentanyl Group

Abstract Background The use of opioids in intrathecal or epidural anesthesia has become popular to optimize postoperative analgesia. However, opioid-induced side effects, such as respiratory depression, nausea, vomiting, urinary retention and pruritus, limit their use. Objectives The purpose of this study was to assess the postoperative analgesic requirements and the analgesic effect of adding magnesium sulphate to epidural bupivacaine compared to addition of fentanyl in patients undergoing lower limb orthopedic surgery under combined spinal epidural anathesia. Patients and Methods After approval of ethical committee in our study and obtaining written informed consent from eligible patients the study was conducted on 60 patients classified to ASA I and II scheduled for lower limb orthopedic surgery. The study presents double armed randomized interventional prospective study including patients allocated into two equal groups each consists of 30 patients. Group (A): patients received magnesium sulphate added to bupivacaine in epidural, Group (B): patients received fentanyl added to bupivacaine in epidural Results The results of their study showed that the maximum level of sensory blockade was significantly higher in the combined fentanyl with magnesium group as compared with fentanyl group alone and magnesium sulphate group alone. The duration of sensory blockade of the combined fentanyl and magnesium group was significantly prolonged as compared to the other two groups as for the other two group the difference in the blockade duration was insignificant Conclusion We concluded that either magnesium sulfate (75 mg) combined with (10 ml) 0.25% Bupivacaine or fentanyl (1 µg/kg) combined with (10 ml) 0.25% Bupivacaine in combined spinal epidural improves intraoperative analgesia and prolongs early postoperative analgesia in lower limb orthopedic surgeries. The duration of analgesia was more prolonged in magnesium sulphate group than in the fentanyl group and this difference was statistically significant.

scholarly journals Comparison of the Efficacy and Safety of Intrathecal Fentanyl 20 μg vs Sufentanil 5 μg as Adjuvant to Bupivacaine 0.5% (12.5 mg) using Combined Spinal Epidural Technique for Lower Limb Orthopedic Surgeries

2016 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Sanjeeta R Umbarkar ◽  
Manju N Gandhi ◽  
Hemlata R Iyer ◽  
Roshan S Thawale
Keyword(s):  
Side Effects ◽  
Lower Limb ◽  
Motor Block ◽  
Demographic Data ◽  
Double Blind Study ◽  
Efficacy And Safety ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

ABSTRACT Aim To compare the efficacy and safety of intrathecal fentanyl 20 μg vs sufentanil 5 μg as adjuvant to bupivacaine 0.5% (12.5 mg) using combined spinal epidural (CSE) technique for lower limb orthopedic surgeries. Background Use of local anesthetics along with opioids intrathecally has been widely reported. We aimed to compare two commonly used opioids as adjuvants to local anesthetic agents in combined spinal epidural techniques. Materials and methods A total of 60 patients were recruited in this prospective, randomized, double-blind study to receive either intrathecal sufentanil 5 μg (Group S) or fentanyl 20 μg (Group F) as adjuvants to 12.5 mg of 0.5% hyperbaric bupivacaine. The onset and duration of sensory and motor block and the pain scores were assessed perioperatively. Duration of analgesia was recorded. The incidence of side effects such as nausea, vomiting, pruritus, shivering. and postdural puncture headache (PDPH) were recorded. Results Demographic data and hemodynamic and respiratory parameters were comparable in both the groups. Onset of analgesia—time to reach highest level of analgesia—was faster in the sufentanil group. Sufentanil group patients had higher grade of motor block. Patients in fentanyl group had higher score of sedation than those of sufentanil group. None of the patients in any group had nausea, vomiting, or pruritus. Conclusion Addition of either fentanyl or sufentanil to intrathecal bupivacaine as an adjuvant in CSE technique enhances the quality of analgesia and motor block with minimal side effects. Hence, this is useful in orthopedic patients, especially in the geriatric age group. How to cite this article Umbarkar SR, Gandhi MN, Iyer HR, Thawale RS. Comparison of the Efficacy and Safety of Intrathecal Fentanyl 20 μg vs Sufentanil 5 μg as Adjuvant to Bupivacaine 0.5% (12.5 mg) using Combined Spinal Epidural Technique for Lower Limb Orthopedic Surgeries. Res Inno Anaesth 2016;1(1):1-4.

scholarly journals Combined spinal‐epidural versus spinal anesthesia comparison of efficacy in terms of analgesia and motor and sensory blockade

2021 ◽  
Vol 8 (4) ◽  
pp. 580
Author(s):  
Akif Mutahar Shah ◽  
Aliya Shah ◽  
Safura Riaz ◽  
Muzzafar Zaman
Keyword(s):  
Epidural Anesthesia ◽  
Lower Limb ◽  
Medical Literature ◽  
Trauma Surgery ◽  
Gynecological Surgery ◽  
Medical Sciences ◽  
Sensory Blockade ◽  
Combined Spinal Epidural ◽  
Spinal Epidural ◽  
Combined Technique

Background: This study was conducted on patients to compare efficacy in terms of motor and sensory blockade and prolonged time of analgesia between spinal and combined spinal epidural methods of anesthesia.Methods: This prospective study was conducted on 60 adult patients of either sex belonging to ASA grade I and II, from June 2014 to June 2016 at Maharishi Markendeshwar institute of medical sciences and research, Mullana in the department of anesthesia.Results: The patients were randomly allocated into two groups of 30 each as defined in text, by a computer-generated number. Proper statistical methods were applied and results obtained. results were statistically significant p<0.05.Conclusions: The Combined spinal epidural technique has been described in the medical literature for use in general surgery, orthopedics, trauma surgery of a lower limb, and urological and gynecological surgery. With this technique, surgical anesthesia is established rapidly, saving 15-20 minutes compared with epidural anesthesia. Patients who received the combined technique had more intense motor blockade than those who received epidural anesthesia alone.

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