Karuna Taksande, G. Swathi Reddy
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Dr. Karuna Taksande1, Dr. G. Swathi Reddy2
1Professor, Department of Anaesthesiology, Datta Meghe Institute of Medical Sciences, Jawaharlal Nehru Medical College, Sawangi, Wardha.
2Post Graduate Student, Department of Anaesthesiology, Data Meghe Institute of Medical Sciences, Jawaharlal Nehru Medical College, Sawangi, Wardha.
Volume - 14,
Issue - 6,
Year - 2021
Background: laminectomy surgeries are usually performed in cases of spinal canal stenosis, disc prolapse etc. It has been reported that the use of regional anesthesia techniques in combination to general anaesthesia has shown better heamodynamic stability intraoperatively, better pain scores and reduced intraoperative blood loss. The present study was conducted to evaluate the efficacy of fusion technique of combining epidural and general anaesthesia in patients undergoing lumbar laminectomies. Aim: To evaluate the efficacy of combined epidural general anesthesia for lumbar laminectomy surgeries with epidural ropivacaine. Materials and Methods: A prospective randomised study was conducted in 100 patients who are scheduled for lumbar laminectomy surgeries belonging to ASA Class I and II age between 40-60 years were randomly allocated into two groups (Group E and Group F) of 50 each. Group E: 12ml of 0.5% Ropivacaine and 50µg fentanyl epidurally. Group F:12ml of Normal Saline and 50µg fentanyl epidurally. The parameters recorded were intraoperative analgesia by heart rate and blood pressure, Rescue analgesia, Blood loss. Results: Intraoperatively requirement of general anesthetics, Heart rate, MBP, Blood loss, is lesser in Group E when compared with Group F. It was observed that longer time to rescue analgesia in group E than in group F. Conclusion: combined epidural general anesthesia with local anesthetic (ropivacaine) with narcotic (fentanyl) is a better technique for anesthetic management of patients posted for lumbar laminectomy. Thus from our study we conclude that combined epidural general anesthesia technique with epidural ropivacaine is a better alternative to general anesthesia providing stable hemodynamics, reducing dose of general anesthetics, less blood loss.
Cite this article:
Karuna Taksande, G. Swathi Reddy. A Randomized Comparative Trial to Study the effect of Preoperative single shot Epidural with Ropivacaine in Lumbar Laminectomy. Research Journal of Pharmacy and Technology. 2021; 14(6):2945-9. doi: 10.52711/0974-360X.2021.00516
Karuna Taksande, G. Swathi Reddy. A Randomized Comparative Trial to Study the effect of Preoperative single shot Epidural with Ropivacaine in Lumbar Laminectomy. Research Journal of Pharmacy and Technology. 2021; 14(6):2945-9. doi: 10.52711/0974-360X.2021.00516 Available on: https://rjptonline.org/AbstractView.aspx?PID=2021-14-6-6
1. Kuthiala G, Chaudhary G. Ropivacaine: A review of its pharmacology and clinical use. Indian J Anaesth. 2011; 55:104-10.
2. Miller RD. Anesthesia. 5th ed. Philadelphia: Churchill Livingstone; 2000.
3. Jellish WS, Thalji Z, Stevenson K, Shea J. A Prospective Randomized Study Comparing Short- and Intermediate-Term Perioperative Outcome Variables After Spinal or General Anesthesia for lumbar Disk and Laminectomy Surgery. Anesth Analg. 1996; 83:559-64.
4. Reid LC, Brace DE. Irritation of the respiratory tract and its reflex effect upon heart. Surg Gynaec and Obst. 1940; 70:157-62.
5. King BD, Harris LC, Greifenstein F, Elder J, Dripps, RD. Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anesthesia. Anesthesiology. 1951; 12: 556-66.
6. Prys-Roberts, Greene LT, Meloche R, Foex P. Studies of anesthesia in relation to hypertension-II. Hemodynamic consequences of induction and endotracheal intubation. Br J Anesth. 1971; 43: 541-47.
7. Zoric S, Stamenkovic D, Stevanovic S et al. Combined spinal epidural and general anesthesia in abdominal surgery. Med Arh. 2003; 57(4): 21-8.
8. Malenkovic V, Zoric S, Randelovic T, et al. Advantage of combined spinal, epidural and general anesthesia in comparison to general anesthesia in abdominal surgery. Srp Arh Celok Lek. 2003; 131(5): 232-7.
9. Khajavi MR, Asadian MA, Imani F, Etezadi F, et al. General anesthesia versus combined epidural/general anesthesia for elective lumbar spine disc surgery: A randomized clinical trial comparing the impact of the two methods upon the outcome variables. Surg Neurol Int. 2013; 4(105).
10. Cherng CH, Yang CP, Wong CS. Epidural Fentanyl speeds the onset of sensory and motor blocks during epidural Ropivacaine anesthesia. AnesthAnalg. 2005; 101: 1834-7.
11. Baron JF, Bertrand M, Baare E, et al. Combined epidural and general anesthesia versus general anesthesia for abdominal aortic surgery. Anesthesiology. 1991; 75: 611-8.
12. Hodgson PS, Liu SS. Epidural lidocaine decreases sevoflurane requirements for adequate depth of anesthesia as measured by the bispectral index monitor. Anesthesiology. 2001; 94: 799-803.
13. Casati L, Galinski FS, Barrera E, et al. Isoflurane Requirements During Combined General/Epidural Anesthesia for Major Abdominal Surgery. Anesth Anal. 2002; 94: 1331-7
14. Modig J. Beneficial effects on intraoperative and postoperative blood loss in total hip replacement when performed under lumbar epidural anesthesia. An explanatory study. Acta Chir Scan Suppl. 1988; 550: 95-103
15. Kida H, Nishikawa N, Matsunami K, et al. The effect of epidural anesthesia on reducing blood loss during upper abdominal surgery. Masui. 1999; 48(3): 265-70.
16. Modig J. Regional anesthesia and blood loss. Acta Anaesth. Scand; 32:44- 48.
17. Dunet F, Pfister C, Deghmani M, et al. Clinical results of combined epidural and general anesthesia procedure in radical prostatectomy management. Can J Urol. 2004; 11: 2200-4.