CONTINUOUS SPINAL ANAESTHESIA: A PROMISING TECHNIQUE FOR PROLONGED LOWER LIMB ORTHOPAEDIC SURGERIES

Abstract

Background: Continuous Spinal Anaesthesia (CSA) is an advancing technique for prolonged lower limb orthopaedic surgeries. It awards prompt anaesthesia and analgesia, controlled sensorimotor blockade along with better haemodynamic stability using titrated and lower doses of Local Anaesthetic (LA) agents. This mode of regional anaesthesia using intrathecal catheter thus demonstrated to be an efcient and safe technique providing lesser incidence of Local Anaesthetic Systemic Toxicity (LAST) and Post Dural Puncture Headache (PDPH). This study integrates our experience with CSA for prolonged lower limb orthopaedic surgeries. Methodology: Our study comprised six cases posted for lower limb orthopaedic surgery belonging to ASA grades I and II. A 20-gauge catheter was threaded in subarachnoid space. The catheter was inserted 3cm intrathecally through 18-Gauge Touhy's needle in L3-L4 interspace. 1ml of hyperbaric Ropivacaine 0.75% with 10µg Dexmedetomidine as an adjuvant was injected. In our case series, we considered aliquots of isobaric Ropivacaine with a concentration of 0.75% for maintenance of anaesthesia wherefore 0.375% for analgesia. All of our patients were Results: hemodynamically stable intraoperatively as well as in the postoperative period. The average duration of analgesia in the postop period was 14-16 hours on the rst top-up. Excellent patient and surgeon satisfaction was experienced. Our case series concludes that CSA is an Conclusion: effective and better option for Single-Shot and Epidural Anaesthesia in lower limb orthopaedic surgeries under skilled expertise