Abstract
Introduction To minimize the time factor of spinal anaesthesia as well as to avoid the side effects of general anaesthesia, ‘rapid sequence spinal’ (RSS) anaesthesia has developed as a novel approach in cases of Category 1 caesarean sections . The aim of this study was to determine the efficacy of different doses of hyperbaric bupivacaine effective for RSS. Method Eighty parturients of Category 1 caesarean sections were allocated into two groups. Group A received 11mg and Group B received 12.5mg of 0.5% hyperbaric bupivacaine intrathecally. Time of arrival to the operation theatre, time of positioning for the subarachnoid block, time of administration of the drug, time of skin incision, time of delivery of the baby and time to attain block up to T 4 dermatome were noted. Results The median time to surgery were 8mins (IQR= 7.25-10) in group A and 8mins in group B (IQR= 8-10) and that to delivery were 12mins (IQR= 10-14.75) in group A and 11mins (IQR= 10-13) in group B, both being statistically insignificant (p value= 0.47 and 0.19). Other time limits were also comparable in both the groups. The haemodynamic parameters did not reveal any significant difference between the groups. Conclusion Category 1 caesarean section can be performed effectively adopting rapid sequence spinal anaesthesia in comparable lower doses as used during routine caesarean section. DOI: http://dx.doi.org/10.4038/slja.v22i2.6360 Normal 0 false false false EN-US X-NONE X-NONE
Highlights
To minimize the time factor of spinal anaesthesia as well as to avoid the side effects of general anaesthesia, ‘rapid sequence spinal’ (RSS) anaesthesia has developed as a novel approach in cases of Category 1 caesarean sections
To minimize the time factor, especially in cases of Category 1 caesarean sections, ‘rapid sequence spinal anaesthesia’ has developed as a novel approach,[3] Category-1 caesarean section is done when there is an immediate threat to life of the mother or fetus[4].This consists of a no-touch spinal technique, consideration of omission of the spinal opioid, limiting spinal attempts, allowing the start of surgery before full establishment of the spinal block, and being prepared for conversion to general anaesthesia if there are delays or problems.[3]
The concept of ‘rapid sequence spinal’ evolved as an alternative to both emergency general anaesthesia, which carries the risk of several fatal complications and the conventional spinal anaesthesia, which is time consuming
Summary
To minimize the time factor of spinal anaesthesia as well as to avoid the side effects of general anaesthesia, ‘rapid sequence spinal’ (RSS) anaesthesia has developed as a novel approach in cases of Category 1 caesarean sections. The concept of ‘rapid sequence spinal’ evolved as an alternative to both emergency general anaesthesia, which carries the risk of several fatal complications and the conventional spinal anaesthesia, which is time consuming It is a conjugation of the two which is based on the principle of performing the subarachnoid block as fast as possible carrying out only the absolute essential steps thereby cutting the permissible time and on the other hand, limiting the attempts of administering the block or even abandoning it in favour of other alternative techniques as is done during rapid sequence induction. Kinsella et al[3] compiled this event with proper documentation initially, based on which several further studies were performed for obtaining a better outcome with minimum possible doses
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