Spinal Anaesthesia with Midline and Paramedian Technique in Pregnant Patients undergoing Lower Segment Caesarean Section Under Spinal Anaesthesia
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 12
Abstract
Background and AIMS: Subarachnoid blockade is widely used due to its simplicity, low cost and reduced complications due to general anaesthesia. Subarachnoid space can be approached from midline or paramedian approach (PMA). Accurate identification of the subarachnoid space is paramount as multiple attempts at needle insertion may cause patient discomfort, backache and Post Dural Puncture Headache (PDPH). The most commonly practiced technique is the midline approach. This approach is technically difficult in pregnant women due to inability to flex the spine adequately. The aim of the study is to compare the characteristics of midline approach (M) vs paramedian (P) for administration of spinal anaesthesia in patients posted for LSCS with respect to number of attempts, highest level of analgesia, duration of anaesthetic procedure and side effects such as blood tap, backache and PDPH after 48 hours. Materials and Method: 60 patients posted for caesarean section under spinal anaesthesia were divided into Group M: Spinal anaesthesia by Midline approach and Group P: Spinal Anaesthesia by Paramedian approach. The number of attempts, highest level of analgesia, duration of anaesthetic procedure and side effects such as blood tap, backache and PDPH after 48 hours were noted. Results: Paramedian group took fewer attempts and less time and a higher level of spinal block was achieved with the midline technique of spinal anaesthesia. Conclusion: Paramedian approach may be a better approach in the parturient as compared to the midline for administering spinal anaesthesia for LSCS.
Authors and Affiliations
Neerja Banerjee
Keywords
Related Articles
- EP ID EP550039
- DOI 10.21088/ijaa.2349.8471.51218.6
- Views 105
- Downloads 0
Comparison between Combined Sciatic-Fascia Iliaca Compartment Block and Unilateral Spinal Anesthesia for Unilateral Lower Limb Surgery: A Retrospective Study
Introduction: We aimed this study to evaluate the efficacy, quality and safety of combined sciatic and Fascia Iliaca Compartment Block with Unilateral Spinal Anaesthesia for selected lower limb surgeries. Materials & Me...
Comparative Study of Dexmedetomidine vs Midazolam Infusion for ICU Sedation
Sedation & Analgesia are generally taken as one entity in intensive care unit and disproportionate use of sedative is associated with adverse outcomes including patients restlessness, excessive sedation, longer ICU (inte...
Perioperative Anaesthesic Concerns for Bariatric Surgeries
As bariatric surgeries is being accepted as safe procedure in India, it demands anesthesiologists to spruce up their knowledge and expertise as they play a vital role in safe perioperative patient management. This would...
Estimation of an Efficient Antiemetic Agent for Prevention of Postoperative Nausea and Vomiting in Children Undergoing Tonsillectomy
Postoperative nausea and vomiting (PONV) remains one of the commonest causes of significant morbidity after tonsillectomy in children. A variety of prophylactic antiemetic interventions have been reported, but there has...
Incidence and Risk Factors for Infections in Post-Operative Cases of Cardiac Surgery
Cardiac surgery creates a high risk for the development of post operative infections. Aims: The objective of this study was to evaluate the incidence, characteristics and risk factors for nosocomial infections after card...