COMPARISON BETWEEN UNILATERAL SPINAL ANESTHESIA AND CONVENTIONAL SPINAL ANESTHESIA IN ORTHOPEDIC LOWER LIMB OPERATION FOR HEMODYNAMIC STABILITY 

Amir Murad Khudadad Boujan a and Bwar Ali Hussein b



a Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 
b Kurdistan Board of Medical Specialties, Sulaimani, Kurdistan Region, Iraq. 
 

Submitted: 17/7/2019; Accepted: 17/2/2020; Published: 21/3/2020

ABSTRACT


Background 

A restricted sympathetic block when performing spinal anesthesia may lead to lower hemodynamic changes.


Objectives 

The aim of this study is to make a comparison between unilateral spinal anesthesia with conventional spinal block in orthopedic lower limb operation regarding hemodynamic stability and vasopressors use.


Materials and Methods

Hyperbaric bupivacaine 0.5% and 27G Quincke spinal needle were used for 42 ASA I and II patients, they were divided randomly into two groups; Unilateral block was performed with patients in sitting position, spinal needle were inserted, needle’s bevel faced to target side 1.5-2 ml of hyperbaric bupivacaine injected within 2 minutes, patient positioned at lateral position with target side downwards for 15 minutes then turned to supine position. Conventional spinal block performed with patients in sitting position, 2-2.5 ml of bupivacaine was injected, and then the patient shifted to supine position.


Results

Systolic and diastolic blood pressure readings at 5, 10, and 15 minutes after induction was significantly higher in unilateral group with more vasopressor use in bilateral group (p value = 0.02). No statistically significant deference regarding pulse rate and arterial oxygen saturation


Conclusion

Unilateral spinal anesthesia using slow, low flow and low volume method in lower limb orthopedic procedures is associated with better hemodynamic stability in comparison to conventional spinal block.



KEYWORDS

Unilateral spinal, Bupivacaine, Lower limb, Hemodynamics.