Efficacy of Spinal Anaesthesia for Laparoscopic Ventral Hernia Repair
DOI:
https://doi.org/10.7439/ijbr.v7i4.3228Abstract
Aim and Objective: Aim of the present study was to evaluate efficacy of spinal anaesthesia in terms of onset, duration and quality of sensoryand motor blockade, hemodynamic stability and perioperative complications. Methods: The study enrolled 30 patients of either sex of ASA grade I and II posted for elective laparoscopic hernia repair. In all the patient spinal anaesthesia was performed using 3 ml 0.5% bupivacaine with 25 mcg fentanyl in L3-L4 inter space. After induction, we studied the various parameters of subarachnoid block. Result: Mean time required for onset of sensory and motor block was 2.46 0.43 (2-3) and 6.93 1.48 (59) minutes respectively. The mean time for reappearance of pain sensation at surgical site (duration of sensory block) was 294.00 62.24 minutes as well as mean time for reappearance of flexion at hip (duration of motor block) was 220.0 46.04 (100 300) minutes. Quality of analgesia and quality of motor block was grade 3 in 20 patients (66.67%) and grade 2 in 10 patients (33.33%). None of the patients had grade 0 and grade 1quality. Conclusion: Spinal anaesthesia with 0.5% bupivacaine (3 ml) and fentanyl (25 mcg) for elective laparoscopic ventral hernia repair was efficacious and has preserved ventilation and hemodynamic changes within physiological limits during pneumoperitoneum with minimal treatable side effects.Downloads
References
Sarli, L, et al. Prospective randomized trial of low?pressure pneumoperitoneum for reduction of shoulder?tip pain following laparoscopy. British journal of surgery 2000;87(9):1161-1165.
Harmon D et al. Acupressure and the prevention of nausea and vomiting after laparoscopy. British journal of anaesthesia 1999; 82(3):387-390.
Ke, Raymond W et al. A randomized, double-blinded trial of preemptive analgesia in laparoscopy. Obstetrics & Gynecology 1998; 92(6) :972-975.
Salman MA et al. Day?case laparoscopy: a comparison of prophylactic opioid, NSAID or local anesthesia for postoperative analgesia. Actaanaesthesiologica scandinavica 2000;44(5): 536-54.
Casati A, Fanelli G, Beccaria P et al. Block distribution and cardiovascular effects of unilateral spinal anaesthesia by 0.5% hyperbaric bupivacaine. A clinical comparison with bilateral spinal block. Minerva Anestesiol 1998; 64:307-312.
Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 1979;51:285-287.
den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev 2008;16:CD006438.
Mason RJ, Moazzez A, Sohn HJ, Berne TV, Katkhouda N. Laparoscopic versus open anterior abdominal wall hernia repair: 30-day morbidity and mortality using the ACS-NSQIP database. Ann Surg 2011;254:641e52.
Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg 2002;89: 534e45.
Lomanto D, Iyer SG, Shabbir A, Cheah WK. Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc 2006;20:1030e5.
Forbes SS, Eskicioglu C, McLeod RS, Okrainec A. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg 2009;96:851e8.
Misra MC, Bansal VK, Kulkarni MP, Pawar DK. Comparison of laparoscopic and open repair of incisional and primary ventral hernia: results of a prospective randomized study. Surg Endosc 2006;20:1839e45.
Sinha, Rajeev, A. K. Gurwara, and S. C. Gupta. "Laparoscopic surgery using spinal anesthesia." JSLS: Journal of the Society of Laparoendoscopic Surgeons 2008;12(2):133.
Critchley LA, Critchley JA, Gin T. Haemodynamic changes in patients undergoing laparoscopic cholecystectomy: Measurement by transthoracic bioimpedance. Br J Ansesth 1993;70: 681-3.
Bejarano Gonzalez- Serna D, Utera A, Gallego JI, Rodiguez R, De La Portilla F, Espinosa JE, et al. Laparoscopic treatment of ventral hernia under spinal anesthesia. Cir Esp 2006;80:168-70.
Dimitrios Symeonidis ,Ioannis Baloyiannis , Stavroula Georgopoulou ,Georgios Koukoulis , Evangelos Athanasiou , George Tzovarasn laparoscopic ventral hernia repair under spinal anaesthesia. International Journal of Surgery 2013; 11:926-929.
Zahl, Kenneth, and Jeffrey L. Apfelbaum. Muscle pain occurs after outpatient laparoscopy despite the substitution of vecuronium for succinylcholine. Anesthesiology 1989;70(3):408-411.
Singh DK. combined spinal and epidural anaesthesia. Indian jouranal of anaesthesia, 2000;(44):19-20.
Chavan G, Chavan A, Ghosh A. Effect of Intrathecal Fentany lon subarachnoid block with 0.5% hyperbaric bupivacaine International J. of Healthcare and Biomedical Research 2014;2(4):67-76.
Imbelloni LE. Spinal anesthesia for laparoscopic cholecystectomy: Thoracic vs. Lumbar Technique. Saudi J Anaesth 2014;8:477-83.
Yasser Ali et al. feasibility of spinal anaesthesia with sedation for laparoscopic general abdominal procedure in moderate risk patients. M.e.j. anesth 2008;19 (5).
Lau H, Wong C, Chu K, Patil NG. Endoscopic totally extraperitoneal inguinal hernioplasty under spinal anesthesia. J laparoendosc adv Tech A 2005;15(2):121-4.
Singh R, Gupta D, and Jain A. The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain after lower segment caesarean section: A randomized control trial. Saudi journal of anaesthesia 2013;7(3): 283.
Ciofolo MJ, Clergue F, Seebacher J, Lefebvre G, Viars P. Ventilatory effects of laparoscopy under epidural anesthesia. Anesth Analg 1990;70: 357-361.
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