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Spread of spinal anaesthesia in obsTetrIc patients-a prospective study

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. INTRODUCTION.

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Spread of spinal anaesthesia in obsTetrIc patients-a prospective study

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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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