Online ISSN: 2515-8260

Keywords : lower limb surgeries


A prospective comparative study to assess block characteristics of 2-chloroprocaine and bupivacaine for lower limb surgeries under spinal anaesthesia

Dr. Samatha Reddy Remata, Dr. Myakala Siddartha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1155-1161

For decades, lignocaine was the local anaesthetic of choice for spinal anaesthesia in ambulatory surgeries. Its advantages are rapid onset of action and good motor block manifested as good muscle relaxation. Its use has become limited because of transient neurologic symptoms and cauda equina syndrome following intrathecal injection. After obtaining the approval of scientific, ethics committee and written informed consent, a total of 100 patients undergoing elective lower limb surgeries under spinal anaesthesia were selected. Patients were explained before operative procedure. Pre-anaesthetic check- up was carried out preoperatively with a detailed history, general physical examination and systemic examination. Airway assessment and spinal column examination was done. In the present study it was observed that there was a statistically difference in the bromage score between groups, score 2 was significantly higher in group II, score 3 was significantly higher in group I p < 0.05. In the present study it was observed that Mean time (in minutes) to pass urine was significantly lower in group I than compared to group II p <0.05.

Evaluate the spectrums of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb surgeries

Dr. Harsh Kasliwal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2535-2541

Background: Sympathetic nervous system and hypothalamic-pituitary adrenal axis constitute the efferent pathway of the perioperative stress response. Surgical tissue trauma and stress results in activation of hypothalamic-pituitary adrenal axis, thereby causing release of corticotrophin releasing hormone (CRH) by hypothalamus. Surgery evokes stress response resulting in increased secretion of counter-regulatory hormones (catecholamines, cortisol, glucagon, and growth hormone) and excessive release of inflammatory cytokines, a state of functional insulin deficiency occurs. Hence, diabetic patients undergoing surgery further develop hyperglycemia in the intra-operative and postoperative period. Aims and Objectives: To evaluate the spectrums of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb surgeries. Materialand Methods: In this study, 62 diabetic (D) patients having preoperative blood glucose between 80 to 120mg/dl, undergoing lower limb orthopaedic surgery, under spinal anesthesia were included. During surgery, blood sugar was measured in capillary blood, using glucometer 10 minutes before initiation of anaesthesia, at time of surgical incision (SI), 30 min after incision and thereafter 1hourly till 4th hour after surgical incision. Statistical analysis was done using SPSS 17.0 software. Results and Observations: In our study Blood glucose (BG) value decreases till 1hr after surgical incision (SI), and then increases till 4th hour after SI. This change in blood glucose values is statistically significant at SI, 2nd hour after SI, 3rd hour after SI and 4thhour after SI. Conclusion: Therefore, hyperglycaemia is very common in surgical patients. Our study demonstrates a linkage between elevated BG and a risk of perioperative complications in diabetic and non-diabetic patients. Spinal anaesthesia blunts surgical stress response and hence, at SI, BG values decrease. But, BG values increase at other times in perioperative period owing to the regression of sensory analgesia.