Comparative Clinical Study between Spinal Anesthesia and Sedation with Local Anesthesia in Orthopedic Procedures of Lower Limb
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 1
Abstract
Introduction: Orthopedic anesthesia presents many challenges to anesthesiologists. Orthopedic procedures of lower limb are performed under general anesthesia, spinal anesthesia, and sedation and local anesthetic infiltration. The orthopedic patients range in age from infant to centenarian. This patient population shows the full spectrum of comorbidities. Many of the procedures are associated with significant post-operative pain. Surgery on isolated extremities can be performed using a variety of regional anesthetic techniques for both anesthesia and post-operative analgesia. Aim of the Study: This study aimed to compare and evaluate the efficacy of sedation with local anesthesia and spinal anesthesia in orthopedic procedures of lower limb, in terms of time taken and subjective analgesia. Materials and Methods: A prospective, randomized controlled clinical trial with two groups of patients, 47 each, was conducted. The age range was 20-55 years. Group A was administered sedation, local anesthesia with fentanyl, midazolam, and propofol infusions were used, and to provide post-operative analgesia, the surgeon used lignocaine and bupivacaine to infiltrate ports and joint cavities. Group B patients were administered spinal anesthesia with 7.5 mg of simple bupivacaine. Different time duration taken during anesthesia and subjective analgesia were evaluated and compared using standard statistical methods. Results: The mean pre-anesthetic period in Group A and B was 36.2 ±4.80 and 58.64 ± 6.22, respectively. The mean time to anesthetize in Group A and B was 26.84 ± 8.20 and 39.50 ± 3.74, respectively. The mean duration of the surgical procedure in Group A and B was 56.48 ± 8.44 and 57.22 ± 3.86, respectively. The mean time spent in recovery room to ambulation in minutes in Group A and B patients was 44.68 ± 6.80 and 74.92 ± 11.24, respectively. The visual analog scale (VAS) score of pain during the surgery in both the groups was 0. The post-operative average VAS score on an average was 3-4 in Group A and 5 to 7 in Group B. Conclusions: The mean values observed for the time of pre-anesthetic period, the mean time to anesthetize, mean duration of the surgical procedure, and mean time spent in recovery room to ambulation were significantly lower in patients anesthetized with sedation and local anesthetic than the spinal block; this technique was found to be a good choice for short orthopedic surgeries of lower limb.
Authors and Affiliations
V K Valsalan, Sathis Chandran
Keywords
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