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Study on Spread of Spinal Anaesthesia in Obstetric Patients

This prospective study by Dr. K. Selvi and co-authors aims to assess the correlation between local anesthesia spread and hemodynamic changes during spinal anesthesia for cesarean section. The study analyzes factors such as analgesia level, hypotension, weight, height, and BMI. Observations include parameters like pulse, BP, and side effects, with comparisons between stable and hypotensive patients. The study shows a significant correlation between the level of block and hypotension, along with other influential factors like weight and height.

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Study on Spread of Spinal Anaesthesia in Obstetric Patients

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  1. Spread of spinal anaesthesia in obsTetrIc patients-a prospective study By Dr.K.SELVI D.A POST GRADUATE Co-authors Prof.Dr.R.SELVAKUMAR Prof Dr.B.CHANDRIKA Prof Dr.A.CHANDRASEKAR COIMBATORE MEDICAL COLLEGE

  2. INTRODUCTION • The correlation between the spread of local anesthesia in the sub-arachnoid space and hemodynamic changes has always been unpredictable and factors responsible for it are being under debate. • This is more frequently experienced in spinal anesthesia for caesarian section.

  3. aim • To asses the level of analgesia and its degree of correlation with the hypotension and other side effects using standard spinal anaesthetic dosage in caesarean section. • To asses the degree of correlation of weight, height,BMI with hypotension.

  4. materials & methods • A sample of 50 patients who underwent Caesarean section (elective & emergency) • 1.8 ml 0.5% of Bupivacaine in L3-L4 space with table positioned horizontally, patient lying in Rt lateral position ,then patient was placed in supine position with a wedge under the right hip. • Fall of more than 20% of systolic BP from the base line value was considered as hypotension and managed with inj.ephedrine in incremental dosage( 6mg )

  5. OBSERVATIONS Parameters like • Pulse • BP • Spo2 • Level of block • Side effects • Time to reach maximum segment & Demographic details like • Height • Weight • BMI

  6. DEMOGRAPHIC PROFILE

  7. OBSERVATIONS • Maximum level of block • Two segment regression time • Level at the end of one hour • Time to reach maximum segment

  8. Percentage of inj.ephedrine usage

  9. Side effects • Restlessness • vomiting

  10. COMPARISON BETWEEN STABLE AND HYPOTENSIVE PATIENTS

  11. CORRELATION WITH LEVEL OF SPINAL BLOCK

  12. SIDE EFFECTS • Restlessness • There is no positive correlation of restlessness with hypotension

  13. SIDE EFFECT • Vomiting • There is positive correlation of vomiting with hypotension.

  14. SUMMARY • So by giving 1.8 ml 0.5% of Bupivacaine in L3-L4,space with table positioned horizontally, patient was placed in supine position with a wedge under the hip. • Incidence of hypotension -62% • Incidence of restlessness-12% • Incidence of vomiting-44%

  15. SUMMARY • As level of block increases severity of hypotension increases. • There is positive correlation of weight,height & BMI with hypotension. • There is a positive correlation between vomiting and hypotension.

  16. CONCLUSION • According to my study level of block significantly decides the degree of hypotension. • Height ,weight,BMI & time to reach maximum segment are also the important co-factors in deciding the incidence of hypotension.

  17. THANK you

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