Tailormade neuraxial block in daycare pelvic brachytherapy: A real challenge for anaesthesiologist.

DR. PRIYANKA MAITRA KARAK; DR. KOEL MITRA

Volume : VIII, Issue : VI, June - 2019

Tailormade neuraxial block in daycare pelvic brachytherapy: A real challenge for anaesthesiologist.

Dr. Priyanka Maitra Karak, Dr. Koel Mitra

Abstract :

Background: Pelvic achytherapy requiring spinal anaesthesia has some noteworthy concerns. Ensuring hemodynamic stability in unsupervised conditions post procedure and speedy recovery for early discharge of the patients remains an anaesthetic challenge. Aim: To find an alternative to conventional intrathecal bupivacaine for faster recovery and early unassisted discharge post achytherapy. Material and method: With ethical approval, study was completed with 60 ambulatory patients diagnosed with carcinoma eligible for pelvic achytherapy were enrolled for spinal anaesthesia. They were randomized by concealed envelope technique and allocated into either Group C(1%choloroprocaine 3ml), Group L(2%lignocaine 0.5ml with 0.5% hyperbaric bupivacaine 1.5ml)or Group B(0.5%hyperbaric bupivacaine 2ml). Intraoperative hemodynamics ,block characteristics was recorded. Full regression of block, time to unassisted ambulation and independent micturition were the primary outcome of study. Incidence of adverse effects was noted. Appropriate statistical tests SPSS. 20 were used for analysis. Result: Block onset, SBP, MAP were significantly better in Group C compared to B , L. Time to two segment and complete regression, independent ambulation, micturition was significantly less with choloroprocaine followed by lignocaine with hyperbaric bupivacaine. Conclusion: Intrathecal choloroprocaine demonstrated best patient hemodynamics, and least time to patient discharge followed by bupivacaine in combination with lignocaine compared to bupivacaine alone.