Spinal Anaesthesia Essay

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Spinal anaesthesia is the most common technique in LSCS and several adjuvants have been tried along with local anaesthetic for prolongation postoperative analgesia. (1) And better postoperative analgesia will improve mother child interaction and improved breastfeeding and infant well-being. Regional anaesthesia for LSCS has distinct advantages over General anaesthesia via avoidance of pulmonary aspiration and difficult in ventilation and intubation due to physiological changes of pregnancy and better postoperative analgesia, less neonatal exposure to drugs. Bupivacaine is being more preferred because of its long acting action and more potent, less neurotoxic than lignocaine. Ketamine a phencyclidine derivative anaesthetic agent
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In Group II, 4 patients had moderate loss of sensation but these had complete motor block and required to be supplemented with 30mg pentazocine and 5mg diazepam.
TABLE 5:-Central nervous system effect : level of Sedation Group I Group II
0 (Normal) 49 (98%) 50
1 (Drowsiness) 1 (2%) NIL
2 (Sleep but arousable) NIL NIL
3 (Unarousable with loss of verbal contact ) NIL NIL In group I only one patient had slight drowsiness from which we did not encounter any problem, while no patient of group II showed adverse effect on central nervous system effects.
TABLE 6:- Changes in Blood pressure Group I Group II
Not significant 33 (66%) 15 (30%)
Mild (11 – 20 mm Hg) 17 (34%) 20 (40%)
Moderate (21 – 30 mm Hg) NIL 10
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