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Abstract

COMPARISON OF NEURALIAXIL BLOCK CHARACTERICTICS AND HAEMODYNAMIC EFFECTS OF SPINAL ANESTHESIA AT L2-3 AND L3-4 LEVEL

Dr. Javid Iqbal*, Dr. S. Mustafa, Dr. Wajahat and Dr. S. A. W. Deva

ABSTRACT

Aims: Compare the spinal anaesthesia at L2-L3 and L3-L4 levels for elective caesarean section on haemodynamic effects, sensory level and patients comfort. Material and Method: patients were randomly divided into two equal groups, thirty patients in each group. Each patient received spinal hyperbaric bupivacaine solution (3ml of 0.5%). Group A received spinal anaesthesia at L2-L3 and Group B received spinal anaesthesia at L3-L4. Patients were monitored for onset of sensory and motor block, total duration of sensory block, level of sensory block, intaoperative haemodynamics and VAS score. Results: There was a significant difference between the two groups in achieving the height of sensory block in the first 30 minutes after intrathecal injection (p<0.001). The median height of the sensory block for patients in group A was T9 whereas in group B, it was T10. The incidence of hypotension showed no statistical difference (p>0.05) between the two groups. The severity of intra operative pain, estimated using a 10 cm VAS, was different and significant between the two groups. The absence of pain (VAS 0) was significantly higher (p=0.047) in group A than in the group B at the beginning of the caesarean section (1st minute) while in the later course of the surgery no statistical difference was found. The onset times of sensory and motor block were significantly shorter in group A than group B. Conclusion: spinal anaesthesia in L2-L3 interspace for caesarean section provides superior analgesia and significantly earlier onset of sensory block as compared to spinal anaesthesia at L3-L4 interspace.

Keywords: spinal anesthesia, sensory level, VAS scores, haemodynamics.


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