IJAR - Indian Journal of Applied Research

Joyee Mondal; Soma Mukhopadhyay

Volume : IX, Issue : VII, July - 2019

A COMPARATIVE STUDY BETWEEN COMBINED SPINAL EPIDURAL ANESTHESIA AND GENERAL ANESTHESIA FOR RADICAL CYSTECTOMY AND URINARY DIVERSION OF BLADDER.

Joyee Mondal, Soma Mukhopadhyay

Abstract :

Background : General anaesthesia (GA) is the most acceptable anaesthetic technique for radical cystectomy with urinary diversion . We have done this study to know whether Combined spinal epidural anaesthesia (CSE) has any advantage for this opreration in respect to blood loss, haemodynamic parameters , postoperative pain control, oral intake and ambulation over GA. Method : This was a prospective comparative study where 40 adult ASA–PS I and II patients of both sex were randomly allocated in GA and CSE group(n=20). Their demographic and base line parameters were comparable. GA group received standard General endotracheal anaesthesia.CSE group received first spinal bupivacaine(H) 15 mg followed by bupivacaine infusion of epidural bupivacaine .5% + fentanyl 2 mcg/ml at 6 ml /hour. Postoperatively patients of both group were sent to post Anaesthesia Care Unit. RESULT: Intraoperative blood loss was significantly less in CSE group compared to GA. Mean Arterial Pressure (MAP), Heart Rate (HR) were significantly less most of the time during operation. VAS score for postoperative pain was better in CSE group which was statistically significant. Oral intake and ambulation was significantly earlier in the CSE group. CONCLUSION: CSE may be considered as an safe and effective alternative to GA for radical cystectomy with urinary diversion .