Spinal Anesthesia Research Articles

A comparative study of ultrasonography versus peripheral nerve stimulator-guided obturator nerve block for transurethral resection of bladder tumor under spinal anesthesia

Background: Transurethral resection of bladder tumor (TURBT) is usually done spinal anesthesia but it does not prevent the obturator reflex leading to bladder perforation, bleeding, or incompletely resection of resection of the tumor which could be prevented by obturator nerve block (ONB) in TURBT. Aims and Objectives: The aim of our study is to compare the effectiveness of ONB by peripheral nerve stimulator (PNS) and ultrasonography (USG) in TURBT and also compare morbidity between USG- and PNS-guided ONB in TURBT under spinal anesthesia. Materials and Methods: Sixty patients were randomly divided into two groups. Group (1) patients had a PNS-guided ONB and Group (2) patients had ONB-guided ONB. The presence or absence of adductor muscles reflexes was recorded. Bladder perforation and bleeding during surgery were also recorded. Results: A success rate of 90% was achieved in the Group (2) compared to 66% in Group (1) which was clinically significant with P=0.049. Complete bladder perforation was detected in four patients in Group (1) whereas no perforation was observed in Group (2). Bleeding was observed in both groups but severe bleeding was present in five patients in Group (1) and required a blood transfusion. Conclusion: We concluded that USG-guided ONB is more efficient and safer as compared to PNS-guided ONB.

A comparative study to assess the effects of intrathecal fentanyl and intrathecal tramadol combined with 0.5% bupivacaine heavy in patients undergoing elective urological surgeries: A prospective randomized study

Background: Urological operations frequently involve the use of spinal anesthesia. In the present scenario, adding different adjuvants to local anesthetic improve its quality and duration has become common. Aims and Objectives: In patients undergoing elective urological procedures, the purpose of this study was to assess the effects of intrathecal fentanyl or tramadol with 0.5% bupivacaine heavy. Materials and Methods: Patients were divided into two groups of 30 patients each, a total of 60 patients aged 20–60 years undergoing elective urological surgeries participated in this prospective, randomized study in which 25 μg fentanyl and 2.5 mL of 0.5% bupivacaine heavy were given to Group F, while 25 mg tramadol and 2.5 mL of 0.5% bupivacaine heavy were given to Group M. The onset and duration of sensory and motor blockage, the duration of analgesia, post-operative Visual Analog Scale score, hemodynamic changes, and adverse effects were evaluated. Results: Fentanyl had a lower mean time of onset for sensory (2:33±0:22 min vs. 4:50±0:33 min) and motor block (3:36±0:28 min vs. 5:52±0:38 min) (P<0.001), the duration of sensory (185.67±3.155 min vs. 152.60±4.264), motor block (172.00±4.177 min vs. 136.40±5.575 min), and post-operative analgesia was longer in the fentanyl group (P<0.001), whereas the incidence of adverse effects such as pruritus, shivering, and nausea was lower in the tramadol group. Conclusion: The quality and duration of spinal anesthesia were found to be significantly increased by the use of fentanyl as an adjuvant in our study. However, tramadol also produced stable hemodynamics and exhibited fewer adverse effects than fentanyl.

The significance of different intervertebral spaces in combined spinal epidural anesthesia in cesarean section.

The number of cesarean sections performed is increasing every year, and obstetric anesthesia is of great interest to physicians and research scholars because of its specificity, high risk, and high complication rate. To investigate the effects of combined spinal epidural anesthesia (CSEA) with different intervertebral spaces during cesarean section on anesthesia effect, anesthesia onset time, anesthesia recovery time, maternal adverse reactions, and neonates. Ninety-two women who underwent cesarean section in our hospital from September 2022 to February 2023 were selected as the study subjects and randomly divided them into two groups (group A and group B), 46 women in each group. Group A underwent CSEA via an L2-3 gap and group B underwent CSEA via an L3-4 gap puncture. The anesthesia effect, anesthesia onset time, sensory recovery time, adverse effects, and neonatal Apgar score were compared between the two groups. When CSEA was performed from L2-3, the anesthesia efficiency was higher, but the difference was not statistically significant. When anesthesia was performed by puncture from L2-3, the onset of anesthesia and recovery time was shorter, and the incidence of intraoperative maternal nausea and vomiting, hypotension, respiratory depression, and other adverse reactions was low with a statistically significant difference. However, the Apgar scores of the neonates in the two groups have no difference. When CSEA is induced via L2-3 interspace, anesthesia has a rapid onset of action, shorter recovery time, and few maternal adverse effects, without affecting the final anesthetic outcome.

Nalbuphine versus morphine: an adjuvant to spinal anesthesia for controlling pain after total knee arthroplasty: a propensity score-matched analysis.

Nalbuphine, a synthetic k-agonist and µ-antagonist, provides efficient pain relief while reducing opioid-related adverse effects. This study aims to compare the efficacy of intrathecal nalbuphine (ITN) with intrathecal morphine (ITM) for post-TKA pain. A retrospective cohort analysis of 131 patients who underwent TKA with spinal anesthesia (SA), a single shot of adductor canal block, and periarticular injections was conducted. The patients were divided into 2 groups, Group N received 0.8mg nalbuphine, and Group M received 0.2mg morphine as an adjuvant to SA. Propensity-score matching was employed to compare the visual analog scales (VAS) of postoperative pain intensity, cumulative morphine use (CMU), maximum knee flexion angle, straight leg raise (SLR) ability, incidence of postoperative nausea and vomiting (PONV), and length of hospital stay (LHS). The mean VAS of group M were significantly lower than group N at 6, 12, 18, and 24h (P < 0.01). Group M had lower CMU than group N at 24h (P < 0.01) and 48h (P < 0.01), while there was no significant difference between groups in terms of knee flexion angle and SLR at any time point. Additionally, 29.3 and 57.9% of patients in group N and M experienced PONV, respectively (p = 0.04), and group N had significantly shorter LHS compared to group M (P < 0.001). Although, intrathecal morphine (ITM) still provides better pain control particularly in the first 24h, patients who received intrathecal nalbuphine (ITN) had significantly fewer incidence of PONV, and shorter LHS.

Is intrathecal bupivacaine plus dexmedetomidine superior to bupivacaine in spinal anesthesia for a cesarean section? A systematic review and meta-analysis.

This study aimed to investigate whether the administration of intrathecal dexmedetomidine as a bupivacaine adjuvant for caesarean section can prolong the duration of analgesia compared with bupivacaine alone. Secondary outcomes included postoperative pain, the time interval to the first analgesic request, the level of sedation, the incidence of adverse effects, and the fetal outcomes. A systematic review and meta-analysis were conducted. The study compared the intrathecal administration of bupivacaine plus dexmedetomidine (group BD) to the intrathecal administration of bupivacaine alone (group B) for cesarean sections. Fourteen publications were included. Among patients who underwent spinal anesthesia for a cesarean section, 514 patients received intrathecal bupivacaine alone, and 533 patients received intrathecal bupivacaine plus dexmedetomidine. The onset of sensory and motor block was essentially the same in both groups; the time for sensory and motor block regression was significantly longer in the BD group. Postoperative Visual Analogue Scale (VAS) values were similar in group BD when compared to group B. Postoperative VAS scores remained consistently low in Group BD compared to Group B, starting from 1 hour after surgery. The level of sedation measured at the end of the cesarean section in both groups was almost similar. No difference in terms of safety, adverse events, and neonatal outcomes was found between the two groups. Use of intrathecal dexmedetomidine for spinal anesthesia in cesarean section significantly prolongs sensory and motor block compared to using bupivacaine alone as an adjuvant. It also improves analgesia after 1 hour with no difference in the incidence of maternal and neonatal adverse effects compared to bupivacaine alone. The optimal dose of dexmedetomidine to use remains to be ingested.

Comparing Analgesic Efficacy of Different-dose Intrathecal Morphine After Cesarean Delivery With Spinal Anesthesia.

Comparing Analgesic Efficacy of Different-dose Intrathecal Morphine After Cesarean Delivery With Spinal Anesthesia.

Ultrasound-Guided Fascia Iliaca Block Versus Pericapsular Nerve Group Block Before Positioning for Spinal Anesthesia in Patients Undergoing Surgery for Neck of Femur Fracture: A Comparative Study.

Introduction Positioning patients with femur fractures for spinal anesthesia can be challenging due to pain. Regional anesthesia techniques, such as the fascia iliaca compartment block (FICB) and pericapsular nerve group block (PENG), have facilitated patient positioning and improved analgesia. This study compared the efficacy of ultrasound-guided FICB and PENG for pain management during the positioning of the patient for spinal anesthesia in neck of femur fracture surgeries. Aim of the study Ultrasound-guided fascia iliaca compartment block versus pericapsular nerve group block before positioning for spinal anesthesia in the neck of femur fracture surgeries. Materials and methods This prospective, randomized, single-blinded, and comparative study was conducted at Dr. DY Patil Hospital, Pune, from November 2022 to January 2024 and included 60 patients with neck and femur fractures scheduled for surgery under spinal anesthesia. Patients were randomly assigned to receive either ultrasound-guided FICB (n = 30) or PENG (n = 30) with 0.25% 20 ml of bupivacaine before positioning for spinal anesthesia. The primary outcome was to assess the Visual Analog Scale (VAS) score for pain before and after the block. Secondary outcomes included assessment of hemodynamic parameters, patient satisfaction, and adverse effects. Results The number of days since fracture in FICB was 2.73±0.98 and in PENG was 3.37±1.9 was comparable with no significant difference between them (p-value =0.11). The mean VAS score after the block was significantly lower in the PENG group compared to the FICB group (3.33±1.73 vs. 4.43±1.3, p = 0.007), indicating better pain relief with PENG. Both techniques were comparable in terms of hemodynamic stability. Patient satisfaction was high and similar in both groups. No significant adverse effects were reported. Conclusion This study observed that the ultrasound-guided pericapsular nerve group block was superior to the fascia iliaca block in providing better analgesia, good patient satisfaction, and hemodynamic stability during positioning for spinal anesthesia.

Pain Management Following Intracavitary Brachytherapy Procedures: A Prospective, Randomized, Double-Blind Study.

Background and objectives Intracavitary applicators are a source of significant discomfort after brachytherapy procedures while undergoing subsequent radiation treatment. With strides towards opioid-sparing anesthesia and analgesia, it's essential to find appropriate substitutes. This procedure requires adequate relaxation of pelvic muscles during the procedure and proper analgesia after the procedure, with the presence of intracavitary applicators, needed for radiation treatment. We studied the day-case safety and analgesic efficacy of adjuvants dexmedetomidine 3 µg and fentanyl 15 µg intrathecally to low-dose 0.5% hyperbaric bupivacaine. Methods Seventy females scheduled for brachytherapy procedures were randomly allocated to receive either Group I (0.5% hyperbaric bupivacaine (1.8 ml) plus 3µg dexmedetomidine (0.3ml)) or Group II (0.5% hyperbaric bupivacaine (1.8 ml) plus 15µg fentanyl (0.3ml)). The primary outcome was to assess and compare the brachytherapy (day-case) feasibility with 3µg dexmedetomidine and 15µg fentanyl (time taken to meet hospital discharge criteria). The secondary outcomes were the absolute duration of spinal analgesia, pain scores, patient satisfaction scores, and any associated adverse events. Data analysis was done using IBM SPSS software for Windows, version 21.0 (IBM Corp., Armonk, NY). Results All patients in Group I were discharged on the same day without any adverse effects. They underwent an intracavitary brachytherapy procedure under spinal anesthesia with stable hemodynamics successfully. The mean time taken to meet hospital discharge criteria in Group II was shorter than in Group I (258.43 ± 27.460 vs. 335.71 ± 21.114). The mean absolute duration of spinal analgesia was significantly longer in Group I as compared to Group II (406.82 ± 51.78 mins vs. 267 ± 16.23 mins) (p<.001). Seventeen patients required rescue analgesia in Group II versus eight in Group I (p<0.025). Conclusion Patients in both groups received excellent analgesia with enhanced patient satisfaction. Three µg intrathecal dexmedetomidine as an adjuvant to low-dose hyperbaric bupivacaine can be used safely in day-case brachytherapy procedures. It provides adequate anesthesia and prolonged spinal analgesia as compared to 15 µg fentanyl.

Misdiagnosed as a perianal abscess: case report of perianal endometriosis.

Perianal endometriosis represents a rare form of endometriosis occurring outside the pelvic cavity. Owing to its infrequency in clinical practice, this condition is highly susceptible to misdiagnosis and inappropriate treatment. This case report details a young female patient who was erroneously diagnosed with a perianal abscess. We conducted a para-anal mass resection under spinal anesthesia, and subsequent histopathological examination definitively confirmed the diagnosis of perianal endometriosis.

Urgent surgical exploration for neonatal torsion under spinal anesthesia

The repeated or lengthy use of general anesthesia (GA) in children under three years old is cautioned against due to potential neurodevelopment effects. Spinal anesthesia (SA) has emerged as a safe and effective alternative for routine pediatric urologic procedures. In this study, we describe the use of SA in the urgent surgical treatment of neonatal testicular torsion. We aim to evaluate the safety and efficacy of SA for urgent scrotal exploration in neonates. We retrospectively collected data on neonates younger than 30 days old undergoing SA for the indication of testicular torsion from May 2018 to June 2022. We recorded patient demographics, adjuvant medications use, and time points for start/stop of spinal injection, procedure, and operating room utilization. Six neonates, with an average age of 1.9 days of life and average weight of 3.4kg, underwent scrotal exploration for testicular torsion using SA. Four patients (67%) required orchiectomy of the nonviable torsed testicle, and all patients underwent orchiopexy of the unaffected testicle. Mean total operative time was 45.3 (SD 11.7) minutes, including Gomco circumcision in five patients. One patient received preoperative intranasal dexmedetomidine for sedation. Mean time for SA administration was 6.3 (SD 5.5) minutes, with a mean total time in the operating room of 77.3 (SD 9.8) minutes. There were no perioperative or postoperative complications. We describe a single institution experience of surgical management of neonatal torsion under SA. In this case series, SA was safely utilized for all neonates involved without the need for conversion to GA or intravenous (IV) sedation. The use of SA is safe and efficacious for urgent scrotal exploration for testicular torsion in neonates, even those under 48h of age. More widespread utilization requires collaboration between pediatric urologists and experienced pediatric anesthesiologists trained in SA.

Setting Sail in Hip Arthroscopy: The “Rudder Technique” for Spinal Needle Access Through the Mid-anterior Portal

Hip arthroscopy is a technically demanding procedure with a steep learning curve. Even accessing the hip joint, if performed improperly, will make the remainder of the case more difficult and potentially cause iatrogenic injury. Much like the rudder of a boat, the spinal needle bevel edge can be steered through tissue in a manner to ensure smooth sailing when accessing the hip. The purpose of this article is to provide a better understanding of how to maximize the capabilities of a bevel-edge needle through use of the “rudder technique” to gain access in a more efficient and atraumatic fashion.

Haemodynamic adaptation profiles after spinal anaesthesia for caesarean section: an UltraSonic Cardiac Output Monitoring study

Haemodynamic adaptation profiles after spinal anaesthesia for caesarean section: an UltraSonic Cardiac Output Monitoring study

EFFECT OF PREOPERATIVE WARMING DURING CESAREAN SECTION UNDER SPINAL ANESTHESIA

Background: Postoperative shivering, hypothermia and Surgical site infections (SSIs) are frequently encountered during Cesarean section (C section). Perioperative warming is a must for surgeries performed under spinal anesthesia, however its importance during C section is unclear. We assessed the functional outcomes of preoperative use of warmers and intravenous fluids (i.v) on parturients undergoing C section under spinal anesthesia. Methods: 45 parturients undergoing an elective C section were randomized into three groups. Group D parturients received warmed i.v fluids (40°C). Group I parturients were given forced air warmers. Group V was the control group. Forced air warmers and i.v fluids were both administered for a period of 15 minutes before anesthetic induction. Core (tympanic membrane) and skin (under arm and thigh) temperatures were noted and shivering was graded. Results: The Core temperature at 45 mins decreased less in Groups D and I than Group V (-0.5°C ± 0.3°C vs -0.6°C ± 0.4°C vs -0.9°C ± 0.4°C, respectively P = 0.004). The under arm temperature at 15 mins and 30 mins exhibited a greater increase in Group I than Group D and Group V (P = 0.001 and P = 0.012, respectively). Thigh temperature increased similarly among the three groups. The incidence of shivering was significantly less in Group I and Group D than Group V (20%, 13.3%, and 53.3%, respectively P = 0.035). Conclusion: Preoperative use of air warmers and warm i.v fluids averts hypothermia and shivering and also reduces the rate of SSIs due to higher core and wound temperature.

ULTRASOUND MEASUREMENT OF THE VERTEBRAL LEVEL OF TUFFIERS LINE IN ELDERLY WOMEN (A COMPARITIVE CROSS SECTIONAL STUDY)

Background:Sometimes , generalizing the vertebral level which is determined by palpation in patients across all the age groups may be inaccurate. This study has aimed to compare the vertebral level intersected by the Tuffiers line in elderly women versus adult womenutilizing an ultrasound in the left lateral decubitus flexed position, to provide a more precise understanding of the potential age-related differences . Methods:We enrolled 50 female patients over the age of 65 (elderly group) and 50 female patients between ages 20-50 (control group) who had been scheduled to undergo surgeries under spinal Anaesthesia. Using ultrasound, we marked the L2–L5 lumbar spinous processes and intervertebral spaces. The most cephalad part was labeled as 1 and the most caudal part was labeled 11. We then identified to which line of these vertebral levels Tuffiers line crossed using an ultrasound. Results:In the elderly group, the median vertebral level of Tuffiers line was found to be located at L2-L3 (median value = 3), whereas in the control group, it was situated at the lower part of L4 (median value = 8). Moreover, asignificant correlation was found between the vertebral level of Tuffiers line and age, weight and BMI in the elderly group (P &lt; 0.001), indicating a significant association between these factors. Conclusions:The ultrasound measurement in the left lateral decubitus flexed position revealed that the Tuffiers line was situated more cranially (towards the head) in elderly women compared to the control group. This indicates that the needle may inserted at a higher level than anticipated, indicating the importance of careful level determination during spinal Anaesthesia in elderly women to avoidcomplications.

Comparing the Effects of Midazolam and Ondansetron in Postoperative Nausea and Vomiting

Background: Nausea and vomiting after a cesarean section (CS) are among the common side effects that cause dissatisfaction among doctors. The aim of this study was to compare the effects of intravenous midazolam and ondansetron on the reduction of nausea and vomiting after spinal anesthesia in CS. Methods: This double-blind clinical trial study was conducted on CS candidates who underwent spinal anesthesia (N=80). After spinal anesthesia, the patients were randomly divided into two groups. Midazolam was administered to one group and ondansetron to the other group. The severity of nausea, the severity of vomiting, and the degree of satisfaction were recorded during surgery and recovery. Results: No significant difference was observed between the two groups in terms of the severity of nausea and vomiting. In addition, the results demonstrated that the level of satisfaction in the midazolam group was higher than that in the ondansetron group, but this difference was not statistically significant (P&lt;0.05). Conclusion: The results of this study showed that midazolam can reduce nausea and vomiting. On the other hand, the results confirmed that both ondansetron and midazolam can have the same effects on reducing nausea and vomiting.

The Relationship Between Interleukin-1β Levels and Visual Analog Scale Value in Preeclampsia Patients Who Received Perioperative C-Sectional Parecoxib With Spinal Anesthesia

Background: Interleukin1β (IL-1β) increases during inflammation and functions as a mediator that terminates endothelial dysfunction and regulates cellular apoptosis in preeclampsia. Parecoxib is a potential agent because of its superiority as an analgesic and anti-inflammatory that can work peripherally and centrally, with minimal side effects on the mother and baby.Objective: This study aimed to determine the relationship between IL-1β levels and visual analog scale (VAS) scores in preeclampsia patients who received parecoxib perioperatively for cesarean section with spinal anesthesia.Methods: Non-experimental cross-sectional research on preeclampsia patients who received perioperative parecoxib and underwent cesarean section with spinal anesthesia as many as 18 people at Arifin Ahmad Hospital, Riau Province, and Bina Kasih Hospital, Pekanbaru. Samples were taken by Consecutive Sampling.Result: There was a moderate negative correlation between IL-1β and VAS (p &lt;0.05; correlation coefficient -0.487).Conclusion: In preeclampsia patients who received parecoxib following a 24-hour spinal anesthetic cesarean surgery, there is a correlation between IL-1β levels and VAS scores.

Comparison of Intradural Bupivacaine With Epidural Levobupivacaine in Lumbar Endoscopic Spinal Surgery

Objective: In lumbar endoscopic spinal surgery, the choice of a regional anesthetic is important for reducing complications and can affect patient recovery and comfort.Methods: A retrospective analysis was conducted of 66 lumbar microdiscectomies (LMDs) under epidural anesthesia (EA) (n=45) or intradural anesthesia (IA) (n=21) performed by the same surgeon and anesthesiologist. The choice of regional anesthesia in LMD (epidural or intradural) differs between anesthesiologists, and the most frequently anesthetic method used in LMD is general or IA.Results: EA may be more reliable than IA, as it enables the surgeon to perform a neurological exploration by requesting the patient to make leg or foot movements during surgery, but few studies have compared these 2 anesthetic methods in LMD. We found that there was a statistically significant difference (p&lt;0.05) between the 2 groups in the postoperative recovery times and in the use of vasopressors during surgery.Conclusion: We suggest that EA reduces the length of time to ambulate, length of stay in the postanesthesia care unit, and the time until initiation of postoperative rehabilitation. Compared to IA, it offers greater hemodynamic stability and allows neurological exploration during surgery.

Efficacy and Safety of Obturator Nerve Block in Transurethral Resection of Bladder Tumors: A Comprehensive Review.

Transurethral resection of bladder tumors (TURBT) is a pivotal procedure in the management of bladder cancer, essential for both diagnosis and treatment. Effective anesthesia is crucial in TURBT to ensure a stable and pain-free operative field, facilitate precise tumor resection, and minimize complications such as the obturator reflex, which can lead to involuntary leg movement and bladder injury. The obturator nerve block (ONB) is a regional anesthesia technique designed to prevent the obturator reflex by blocking the obturator nerve, which innervates the adductor muscles of the thigh. This comprehensive review evaluates the efficacy and safety of ONB in TURBT. It begins by discussing the anatomical and physiological aspects of the obturator nerve, followed by a detailed examination of various ONB techniques, including ultrasound-guided and landmark-based methods. The review assesses the impact of ONB on pain management, reduction of adductor muscle spasms, and overall improvement in surgical conditions and patient satisfaction. Additionally, it explores the incidence and types of complications associated with ONB, such as hematoma, nerve injury, and local anesthetic systemic toxicity (LAST). It compares ONB with other anesthesia techniques used in TURBT, such as general, spinal, and epidural anesthesia. A critical analysis of key clinical studies and meta-analyses is presented to provide a comprehensive understanding of the current evidence on ONB efficacy and safety. Future directions and innovations in ONB techniques, including advances in imaging and nerve localization, are also discussed. Practical recommendations for implementing ONB in clinical practice, including guidelines for clinician training and patient selection criteria, are provided. This review aims to inform clinicians about the benefits and risks of ONB in TURBT, guide clinical practice, and identify areas for future research to optimize anesthesia management in bladder cancer surgery.

Analyzing Substance Levels and Pain Perception in Painless Labor: The Impact of Spinal Epidural Analgesia.

Inflammation affects labor by influencing contractions and dilation. Pain, often linked to tissue ischemia, involves mediators like nitric oxide (NO), TNF-α, and substance P (SP). Neuraxial analgesia, including combined spinal epidural analgesia (SEA) with levobupivacaine, is preferred for its effectiveness and minimal side effects in painless labor. Understanding the impact of painless labor techniques on biomolecular processes such as NO, TNF-α, and substance P levels is crucial for improving pain management strategies. This study investigates these effects in parturients undergoing SEA with levobupivacaine, contributing to the development of novel pain medications and enhancing obstetric care. This experimental study, conducted at a General Hospital in Indonesia, involved 60 expectant mothers in labor or in the third trimester, expected to give birth vaginally at Permata Hati Metro Hospital. Blood serum was used for analysis, and serum NO, TNF-α, and SP levels were assessed using ELISA kit. There's a significant decrease in NO levels before and post-treatment in the SEA group compared to the control group (p < 0.05). However, no significant difference in TNF-α levels was observed between groups before and after treatment (p > 0.05). Additionally, there was no significant difference in SP levels between groups before treatment, but a significant difference was seen after treatment (p < 0.05). SEA significantly reduced labor pain compared to the control group (P < 0.05), with notable improvements in vital signs and APGAR scores, while also shortening labor duration (P < 0.001). In conclusion, SEA with levobupivacaine during painless labor reduces NO levels significantly and shows a trend of decreasing TNF-α and substance P levels, although not statistically significant, with clinical benefits for both patients and babies.

Effect of Atropine as Premedication to Prevent Vasovagal Attack in Male Patients Undergoing Spinal Anaesthesia

Background: Spinal anaesthesia (SA) is associated with many complications among which the most common side effects are hypotension and bradycardia, The aim of the current study was to assess the effects of prophylactic atropine in prevention of spinal anaesthesia induced hypotension and bradycardia in male. Aim of the Study: The aim of the current study was to assess the effects of prophylactic atropine in prevention of spinal anaesthesia induced hypotension and bradycardia in male. Method: Seventy (70) patients aged 25-60 years old, they had more than one type of surgery. the patients were monitored by the anaesthesiologist, and we monitored the patient’s vital sign related to the operation period, such as blood pressure, heart rate, body temperature, and oxygen saturation, for patients who received atropine before the operation and patients who received atropine during the operation. Results: There were statistically significant differences in the results of the men who received atropine at the beginning of the operation, while for the people who did not receive atropine at the beginning of the operation, there were values that were not statistically significant in the variables of systolic and diastolic blood pressure and heart rate within 5 minutes of receiving spinal anaesthesia. Conclusion: Prophylactic atropine within 1 min of induction of spinal anaesthesia in male patients undergoing surgery reduce the incidence of hypotension and bradycardia.