Spinal Anesthesia Research Articles

Complications of intrathecal baclofen therapy in children and young adults

OBJECTIVE The primary objective of this study was to determine the frequency and nature of complications that occur during intrathecal baclofen (ITB) therapy, including nonsurgical complications as well as complications associated with both implantation surgeries and subsequent revisions. METHODS The authors retrospectively reviewed the medical records of all patients who had baclofen pumps implanted at a tertiary children’s hospital from 2006 through June 2019. The study employed appropriate descriptive statistics and statistical models to analyze patient demographics, improvements in tone, and clinical complications. The authors evaluated the associations of complications as well as changes in modified Ashworth Scale (MAS) scores with various preexisting conditions (e.g., presence of gastrostomy tubes [G-tubes] and ventriculoperitoneal [VP] shunts) and surgical variations (e.g., use of newer [Ascenda] catheters and subfascial versus subcutaneous catheter tunneling). RESULTS One hundred forty-two pumps were implanted. Complications occurred in 111 patients (78.2%). The most frequent complications were catheter complications and pseudomeningoceles, each of which occurred in 63 (44%) patients. On multivariable analysis, pseudomeningoceles and percutaneous CSF leaks were significantly less likely when intrathecal catheters were placed via laminotomy versus spinal needle (OR 4.6, p = 0.044), and when catheters were passed from the posterior incision to the abdominal pump pocket deep to the thoracolumbar fascia rather than superficial to it (OR 2.7, p = 0.008). Preexisting G-tubes and VP shunts at the time of pump implantation were not associated with a significantly increased likelihood of pump malfunction or infection. Ascenda catheters were significantly less likely to have disconnections (p < 0.001) and obstructions (p = 0.016), and overall were less likely to have any catheter-related complications (p = 0.01). Patients with preexisting VP shunts at the time of implantation had a significantly greater mean decrease in MAS scores in both their lower extremities (1.8, p = 0.003) and upper extremities (1.3, p = 0.002) than did patients without shunts. CONCLUSIONS Various complications are associated with ITB therapy, most commonly catheter complications and pseudomeningoceles. There have been fewer catheter complications associated with the newest catheter model, while pseudomeningoceles have become less frequent since the surgical technique was modified to prevent them. VP shunts and G-tubes are not associated with significantly higher complication rates and shunts seem to be associated with greater efficacy of ITB therapy, as represented by a greater mean improvement in MAS scores.

Arthroscopic Debridement and Resection of a Bennett Lesion in a Collegiate Baseball Pitcher

Background: Overhead throwing athletes are predisposed to ossification along the superior to inferior posterior glenoid rim, termed thrower's exostosis or a Bennett lesion. These lesions can result in posterior shoulder pain during throwing and decreased shoulder range of motion, and they can be associated with posterior labral tears and undersurface rotator cuff tears. In this video technique, we describe the arthroscopic debridement and resection of a symptomatic unstable Bennett lesion in a collegiate baseball pitcher who had unsuccessful nonoperative treatment. Indications: Currently, there is no standard treatment algorithm for Bennett lesions. Arthroscopic intervention is typically indicated in overhead throwers who have unsuccessful nonoperative protocols, including stretching of the posterior capsule, strengthening of the rotator cuff, and injections. Technique Description: In the lateral decubitus position, standard posterior viewing and anterior working arthroscopic portals are created followed by diagnostic arthroscopy. A high anterior accessory portal is created to view the posterior labrum and evaluate for tears. The location of the Bennett lesion is determined using a switching stick or probe. In this case, an accessory posterior viewing portal and capsulotomy are created under spinal needle visualization and a 70° scope is utilized for an improved view. Through the capsulotomy, a motorized shaver and radiofrequency wand is used to work along the posterior inferior glenoid neck to expose the lesion. Once the lesion is fully demarked, a hooded bur is utilized to debride the entirety of the lesion back to the smooth bony surface of the glenoid neck. After resection, the capsule is left open to avoid overtightening the posterior capsule in overhead throwing athletes. Results: Arthroscopic debridement and resection of a symptomatic Bennett lesion in a collegiate baseball pitcher allowed the patient to return to pain-free pitching at the same level of collegiate play the following season. Discussion/Conclusion: An unstable Bennett lesion can be a source of pain in the overhead throwing athlete. If nonoperative treatment modalities fail to resolve symptoms, arthroscopic debridement and excision of this lesion utilizing a posterior capsulotomy and accessory posterior viewing portal as described in this video technique is a safe and effective surgical option. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Fatal Bladder Carcinoma in Woman with Human Immunodeficiency Virus: A Case Report

Background: Chronic human immunodeficiency virus (HIV) infection is associated with an increased incidence of Non-Acquired Immunodeficiency Syndrome (non-AIDS) defining cancers. To date, only a limited number of cases of bladder cancer have been linked with HIV infection in women. We sought to describe the clinical characteristics of HIV-associated bladder cancer. Methods: A 54-year-old female patient presented with symptoms of an occlusive syndrome. Medical examination was followed by a CT scan. The imaging revealed a significant finding. There was a noticeable process within the bladder. Further evaluation and management were recommended. Results: Spontaneous urinary cytology revealed the presence of malignant cells. An endoscopy was performed under spinal anesthesia, uncovering a large sessile tumor with necrotic areas located on the ventral aspect and dome of the bladder. Due to the severity of the condition, a palliative resection was carried out. Subsequent histological examination identified the tumor as a high-grade urothelial carcinoma, with evidence of muscle invasion. This diagnosis confirmed the aggressive nature of the disease, highlighting the necessity for further medical management and intervention. Conclusion: Bladder cancers in HIV-infected patients are rare but can occur in relatively young individuals with a low nadir CD4 cell count. These cancers often exhibit aggressive pathological features and can be fatal.

The Relationship of Work, Social Culture, and Family Support In Providing Exclusive Breastfeeding to Mothers of Babies (0-6 Months) in The Working Area of The Puskesmas Tana Lia, Tana Lia District

Spinal anaesthetic needle prick pain is an unpleasant experience that results in losses from spinal anaesthesia, so it needs to be treated. Deep breathing relaxation techniques and lavender aromatherapy are effective non-pharmacological pain management methods. In addition to increasing comfort, reducing pain can also provide convenience and speed in the process of injecting spinal anesthetic needles. The purpose of this study was to investigate the effects of deep breathing relaxation techniques and lavender aromatherapy on the pain intensity of spinal anaesthetic needle pricks at Kardinah Hospital, Tegal. This study employed a quasi-experiment research method, utilizing a two-group post-test design. The sampling technique used purposive sampling with a total of 72 respondents who were divided into groups of deep breathing relaxation techniques and lavender aromatherapy. Data analysis used the Mann-Whitney The results of the non-parametric statistical test with the Man Whitney test obtained p = 0.000 (p <0.05), so Ha was accepted, meaning that there was a difference in the pain intensity of spinal needle stick anesthesia given deep breathing relaxation techniques and lavender aromatherapy. rapy. The study concluded that there were differences in the pain intensity of spinal anaesthetic needle pricks at Kardinah Hospital, Tegal, between deep breathing relaxation techniques and lavender aromatherapy.

Perbedaan Teknik Relaksasi Pernafasan Dalam dengan Aromaterapi Lavender terhadap Intensitas Nyeri Tusukan Jarum Anestesi Spinal

Spinal anaesthetic needle prick pain is an unpleasant experience that results in losses from spinal anaesthesia, so it needs to be treated. Deep breathing relaxation techniques and lavender aromatherapy are effective non-pharmacological pain management methods. In addition to increasing comfort, reducing pain can also provide convenience and speed in the process of injecting spinal anesthetic needles. The purpose of this study was to investigate the effects of deep breathing relaxation techniques and lavender aromatherapy on the pain intensity of spinal anaesthetic needle pricks at Kardinah Hospital, Tegal. This study employed a quasi-experiment research method, utilizing a two-group post-test design. The sampling technique used purposive sampling with a total of 72 respondents who were divided into groups of deep breathing relaxation techniques and lavender aromatherapy. Data analysis used the Mann-Whitney The results of the non-parametric statistical test with the Man Whitney test obtained p = 0.000 (p <0.05), so Ha was accepted, meaning that there was a difference in the pain intensity of spinal needle stick anesthesia given deep breathing relaxation techniques and lavender aromatherapy. rapy. The study concluded that there were differences in the pain intensity of spinal anaesthetic needle pricks at Kardinah Hospital, Tegal, between deep breathing relaxation techniques and lavender aromatherapy.

Comparison of erector spinae plane and transversus abdominis plane block for postoperative analgesia after caesarean delivery under spinal anaesthesia: A randomised controlled trial

BackgroundTruncal blocks contribute to multimodal analgesia that enhances early recovery after caesarean delivery. The transversus abdominis plane (TAP) block is an established technique that offers somatic abdominal wall analgesia. The erector spinae plane (ESP) block is a fascial plane technique that may offer additional visceral analgesic effects. This study hypothesized that ESP block would offer superior analgesic efficacy to TAP block in women undergoing caesarean delivery under spinal anaesthesia. MethodsSixty-six ASA physical status grade 1–3 (≥18 years) patients undergoing elective caesarean delivery under spinal anaesthesia were randomly allocated to receive either bilateral ultrasound-guided TAP (N = 33) or ESP blocks at the T9 vertebral level (N = 35). The primary outcome measure was 24-hour cumulative morphine consumption. The secondary outcomes included time to first analgesic request, duration of block placement, numeric rating scale (NRS) pain scores at rest and movement, effect of pain on activities of daily living (ADLs) and care for the infant, patient analgesic satisfaction, frequency and severity of opioid-related side effects. ResultsThere was no statistically significant difference in mean (95% CI) 24-hour cumulative morphine consumption between groups: 32.0 (27.0 to 37.0) mg with TAP versus 27.0 (19.9 to 34.0) mg with ESP (p = 0.16). The mean (SD) duration of block placement was longer for ESP than for TAP blocks (10.7 (2.2) minutes versus 9.0 (2.5) minutes; p = 0.004). There were no significant differences in the other secondary outcomes. ConclusionThis study found similar postoperative opioid use and analgesic efficacy between ESP and TAP block after caesarean delivery performed under spinal anaesthesia.Trial Registration: South African National Clinical Trial Registry (DOH-27-102022-5278): https://sanctr.samrc.ac.za/TrialDisplay.aspx?TrialID=8100, Pan African Clinical Trials Registry (PACTR202301645957324): https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24267.

Effects of Post-Operative Cognitive Dysfunction after Spinal Anesthesia between Geriatric and Middle-Aged Patients

Effects of Post-Operative Cognitive Dysfunction after Spinal Anesthesia between Geriatric and Middle-Aged Patients

The Role of Spinal Anaesthesia with and without Intrathecal Opioid Coadministration in Improving Oncologic Outcomes after Endoscopic Transurethral Cancer Surgery

Spinal anaesthesia (SA) (compared to general) improves postoperative oncologic outcomes in transurethral resection of the bladder tumour (TURBT) for non-muscle invasive bladder cancer (NMIBC). Intrathecal coadministration of opioids does not affect NK cells function, and improves postoperative opioid sparing as well. There are no comparative data on oncologic outcomes of SA with/without intrathecal opioid in TURBT, which is the aim of our study. Seventy ASA I-III patients with NMIBC, aged ≥ 43 (range 43-90), who underwent one or more TURBT under SA were examined retrospectively. Of them, 36 received levobupivacaine 15 mg (L group) and 34 levobupivacaine 12.5 mg + fentanyl 12.5 mcg (LF group) intrathecally. All patients received scheduled Paracetamol 1.0 g/6 h, optional NSAIDs and as needed Tramadol as well. Data regarding demographics, ASA and CCI scores, analgesics consumption, urethrotomies, tumour-related factors (size, number, grade, stage, prior disease-recurrence, adjuvant therapy), tumour risk (low, intermediate, high), oncologic outcomes (recurrence rate/free time after TURB during the regular cystoscopy every 3 months/first year, every six months thereafter) were explored as well. LF patients were older, with less analgesics consumption and with a tendency towards longer recurrence-free time compared to L patients (p=0.074). The recurrence at three months along with prior and new disease-recurrences comprise our minority (n=27) with aggressive course of the disease. Among the rest the majority, LF subgroup (n=19) had lower recurrence rate than L subgroup (n=24) (p=0.03). As part of multimodal analgesic strategy, SA with intrathecal opioid coadministration may play a significant complementary role regarding oncologic outcomes after TURBT for NMIBC.

Dexamethasone as a perineural adjuvant to a ropivacaine popliteal sciatic nerve block for pediatric foot surgery: a randomized, double-blind, placebo-controlled trial

BackgroundThis study assessed the effect of perineural dexamethasone on block duration, opioid requirement, blood glucose levels, and stress response to surgery as measured by the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte...

The impact of spinal anesthesia on cardiac function in euvolemic vascular surgery patients: insights from echocardiography and biomarkers.

Existing evidence of the effect of spinal anesthesia (SA) on cardiac systolic function is scarce and inconclusive. This study aimed to evaluate the effects induced by a single injection of SA for elective vascular surgery on left (LV) and right (RV) ventricular systolic performance using transthoracic echocardiography (TTE). A prospective study. Single-center study, university hospital. Adult patients undergoing elective vascular surgery with SA. During patients' evaluations fluid administration was targeted using arterial waveform monitoring. All patients underwent TTE studies before and after SA induction for the assessment of indices reflective of LV and RV systolic function. Blood samples were drawn to measure troponin and brain natriuretic peptide (BNP) levels. A total of 62 patients (88.7% males, 71.00 ± 9.42 years) were included in the study. The primary outcome was the difference before and after SA in LV ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE). In total population, LVEF significantly increased after SA 53.07% [16.51]vs 53.86% [13.28]; p < 0.001). End-systolic volume (ESV, 69.50 [51.50] vs. 65.00 [29.50] ml; p < 0.001) decreased while stroke volume (SV) insignificantly increased (70.51 ± 16.70 vs. 73.00 ± 18.76ml; p = 0.131) during SA. TAPSE remained unchanged (2.23 [0.56] vs. 2.25 [0.69] mm; p = 0.558). In patients with impaired compared to those with preserved LV systolic function, the changes evidenced in LVEF (7.49 ± 4.15 vs. 0.59 ± 2.79; p < 0.001), ESV (-18.13 ± 18.20 vs-1.53 ± 9.09; p < 0.001) and SV (8.71 ± 11.96 vs-1.43 ± 11.89; p = 0.002) were greater. This study provides evidence that SA in patients undergoing elective vascular surgery improved LV systolic function, while changes in RV systolic function are minimal.

Median effective dose of spinal ropivacaine in combined spinal and epidural anesthesia for emergency cesarean delivery following failed vaginal delivery with epidural labor analgesia: a single-blind, sequential dose-finding study.

This study aimed to estimate the median effective dose of intrathecal isobaric ropivacaine without opioid required for adequate cesarean delivery anesthesia after epidural labor analgesia. Patients aged 20-40years with American Society of Anesthesiology scores of I-II, body mass index ≤ 36, who underwent emergency cesarean delivery after failed vaginal delivery with epidural analgesia of a duration ≤ 6h were included in the study. After removal of the epidural used for labor analgesia, a new combined spinal epidural was performed, and a dose of intrathecal isobaric ropivacaine without opioid was administered. The dose was determined using up-down methodology, with the starting patient's dose set to 12mg. Adequate anesthesia, defined as a pinprick level no lower than T6 at 5min after ropivacaine administration, resulted in the next patient receiving a dose of ropivacaine 1mg higher, and inadequate anesthesia 1mg lower. The primary outcome was the median (95% confidence interval (CI)) dose of spinal ropivacaine required for adequate cesarean delivery anesthesia. Of the 46 patients included in the study, 40 were analyzed. The median spinal ropivacaine dose was 8.11mg (95% CI 7.29-8.93mg) by the Dixon and Mood method and 8.06mg (95% CI 6.93-9.00mg) by isotonic regression. Two patients had high spinal anesthesia. Our findings suggest that for 50% of patients undergoing cesarean delivery after failed vaginal delivery with epidural analgesia, an 8-mg spinal dose of isobaric ropivacaine without opioid provides an anesthesia level no lower than T6 at 5min.

The Global Reading Room: A Patient With Headaches After Spinal Anesthesia.

The Global Reading Room: A Patient With Headaches After Spinal Anesthesia.

Fascicular injury is rare following needle transfixion: a study on median and ulnar isolated human nerves

BackgroundNeedle trauma has been associated with peripheral nerve injury and neurological dysfunction. However, inadvertent needle puncture is frequent while postblock dysfunction is rare. We conducted a cadaveric study to evaluate...

Prilocaine vs bupivacaine in spinal anesthesia for urologic endoscopy: clinical trials &amp; historical overview

Introduction. In the evolving landscape of anesthetic practices for short-duration urologic procedures, the quest for an anesthetic agent that balances efficacy with minimal side effects remains a significant clinical challenge.The objective was to compare the efficacy and safety of 2% hyperbaric prilocaine and 0.5% hyperbaric bupivacaine in spinal anesthesia.Materials and methods. A comparative analysis was performed in terms of onset and duration of sensory and motor block, incidence of side effects (hypotension and bradycardia), and overall patient outcomes in urologic endoscopy. The research sample was divided into two groups, each consisting of 20 patients. In one case, spinal anesthesia was performed using 2% hyperbaric prilocaine (40 mg) + fentanyl 25 mcg, in the other – 0.5% hyperbaric bupivacaine (10 mg) + fentanyl 25 mcg.Results. Prilocaine offers a faster onset of sensory and motor block and a shorter duration of sensory block compared to bupivacaine. Prilocaine also showed a quicker recovery of full motor function and had a significantly lower incidence of side effects such as hypotension and bradycardia.Conclusion. These results suggest that 2% hyperbaric prilocaine could be an alternative to 0.5% hyperbaric bupivacaine in spinal anesthesia for urologic endoscopy, especially in procedures requiring quick recovery. The promising results of prilocaine in such short-duration surgeries can also prompt a reevaluation of anesthesia protocols across various surgical interventions and lead to enhanced patient outcomes, emphasizing safety, comfort, and efficacy of surgical care.

Retrospective comparison of the effects of remimazolam and dexmedetomidine on postoperative delirium in elderly patients undergoing orthopedic surgery of the lower extremities under spinal anesthesia.

Remimazolam is often used for perioperative sedation due to its rapid onset and offset. However, the possible association between remimazolam and postoperative delirium (POD) remains undetermined. The present study evaluated whether remimazolam increased the incidence of POD compared with dexmedetomidine in elderly patients undergoing orthopedic surgery of the lower extremities. This retrospective study included patients aged ≥ 65years who had undergone orthopedic surgery of the lower extremities under spinal anesthesia from January 2020 to November 2022 and were sedated with continuous intravenous infusion of dexmedetomidine or remimazolam. The incidence of POD was assessed through a validated comprehensive review process of each patient's medical records. The effect of remimazolam on the occurrence of POD compared with dexmedetomidine was evaluated by propensity score weighted multivariable logistic models. A total of 447 patients were included in the final analysis. The crude incidence of POD within 3days after surgery was 7.5% (17/226) in the dexmedetomidine group and 11.8% (26/221) in the remimazolam group, increasing to 9.7% (22/226) and 15.8% (35/221), respectively (p = 0.073), within 5days. The multivariable models showed that, compared with dexmedetomidine, intraoperative sedation with remimazolam significantly increased the occurrence of POD within 3days (odds ratio [OR] 2.21, 95% confidence interval [CI] 1.31 to 3.82, p = 0.003) and 5days (OR 2.10, 95% CI 1.32 to 3.40, p = 0.002). Compared with dexmedetomidine, remimazolam infusion may be associated with a higher risk of POD in elderly patients undergoing orthopedic surgery of the lower extremities under spinal anesthesia.

The Analgesic Effect of Transversalis Fascia Plane Block After Caesarean Section Under Spinal Anaesthesia With Intrathecal Morphine: A Randomized Controlled Trial

The Analgesic Effect of Transversalis Fascia Plane Block After Caesarean Section Under Spinal Anaesthesia With Intrathecal Morphine: A Randomized Controlled Trial

Comparing the Effect of Intravenous Tramadol and Intravenous Nalbuphine in Addition to Midazolam for the Control of Shivering after Spinal Anesthesia

Introduction Shivering is a common complication during neuraxial anesthesia, leading to metabolic and cardiovascular challenges. Existing treatments vary in effectiveness, and this study compares intravenous tramadol and nalbuphine, both administered with midazolam, for shivering control. Objectives To evaluate and compare the efficacy of IV tramadol and IV nalbuphine, alongside midazolam, in controlling post-spinal anesthesia shivering. Materials and Methods A prospective, randomized comparative clinical study involving 100 patients undergoing various surgical procedures under spinal anesthesia. Patients were divided into two groups to receive either IV Tramadol or IV Nalbuphine with midazolam. Parameters like shivering severity, time to cessation, recurrence, and side effects were recorded and analyzed. Results Both tramadol and nalbuphine effectively controlled shivering with comparable response times and side effect profiles. There was no significant difference in the incidence of nausea, vomiting, and sedation between the groups. Hemodynamic stability was maintained throughout the study. Conclusion IV tramadol and IV nalbuphine, in conjunction with midazolam, are effective in controlling post-spinal anesthesia shivering, with similar efficacy and safety profiles. They provide valuable options for clinicians in managing this common anesthetic complication. Further research is encouraged for more refined application in diverse patient populations.

Patient With Kyphoscoliosis And Bifid Uvula For Hernioplasty Managed Under Low Dose Spinal Anaesthesia At Sub District Hospital

Patient With Kyphoscoliosis And Bifid Uvula For Hernioplasty Managed Under Low Dose Spinal Anaesthesia At Sub District Hospital

Prophylactic phenylephrine infusion versus treatment with vasopressor bolus as needed during non-urgent cesarean delivery and neonatal acidemia: a retrospective cohort study (2016–2021)

IntroductionProphylactic vasopressor administration reduces spinal hypotension during cesarean delivery, however the effects of vasopressor administration on neonatal acidemia remain uncertain. We examined the occurrence of neonatal acidemia in the setting of non-urgent cesarean delivery and compared outcomes between cases receiving prophylactic phenylephrine infusion versus cases treated with boluses of phenylephrine. MethodsRetrospective cohort study with ethical approval, comparing non-urgent cesarean delivery cases performed under spinal anesthesia (2016 to 2021), receiving either prophylactic phenylephrine infusion or boluses as needed.Data were collected from anesthesia and labor ward electronic medical records. Records with missing pH or missing blood pressure data were excluded. The independent variable was prophylactic phenylephrine administration, a strategy implemented following international recommendations in 2018. The main outcome was neonatal acidemia, defined as umbilical artery pH < 7.1. The secondary outcome was maternal hypotension, defined as at least one systolic blood pressure (SBP) measurement below 100 mmHg or below 80% baseline. ResultsA total of 4392 patients were included in the final analysis; 1318 (30.0%) received prophylactic phenylephrine infusion. Neonatal acidemia (umbilical artery pH < 7.1) occurred in 28 (2.1%) cases receiving prophylactic phenylephrine versus 50 (1.6%) treated with boluses as needed (p = 0.188). Prophylactic phenylephrine infusion was not associated with occurrence of neonatal acidemia (aOR 0.83; 95% CI 0.52 to 1.33, p = 0.435). Prophylactic phenylephrine infusion was associated with a reduced spinal hypotension rate when defined as SBP < 100 mmHg (OR 0.47; 95% CI 0.37 to 0.57; p < 0.001), with similar results when hypotension was defined as a drop below 80% or 90% of baseline SBP. ConclusionIn this pragmatic study, prophylactic phenylephrine infusion was associated with a reduction in maternal spinal hypotension, but not reduced neonatal acidemia.

A Comparative Study of Combined Spinal Epidural Anesthesia Versus Spinal Anesthesia in Major Lower Limb Orthopedic Surgeries.

Background Neuraxial blockade includes epidural and spinal anesthesia (SA) that have gained wide acceptance for major lower limb orthopedic surgery. Both techniques are competent in rendering surgical anesthesia and pain relief, with specific advantages and disadvantages. SA has the merits of rapid onset and adequate anesthesia with a small volume of the drug but has significant hypotension and unpredictable duration. Epidural anesthesia allows for finer control over analgesia and the duration of anesthesia but requires more substantial volumes of drugs and is slower in onset. Combined spinal-epidural anesthesia (CSEA) combines the rapid commencement of action of SA with flexibility in epidural anesthesia, thus optimizing the management of the intraoperative and postoperative phases. This study aims to evaluate hemodynamic changes, compare the severity and duration of sensory and motor block, and track any problems related to CSEA and SA in major lower limb orthopedic procedures. Additionally, this study contrasts the hemodynamic, motor, and sensory changes in the two groups. Methodology A total of 30 individuals were randomized to one of two groups in this prospective comparative trial, which included 60 patients receiving major lower limb orthopedic surgery and meeting the American Society of Anesthesiologists physical status I-II criteria. Group A received CSEA, and Group B received SA. The degree and duration of sensory and motor blockade, hemodynamic changes, and complications were all recorded. A p-value of less than 0.05 was used to evaluate statistical significance using Student's t-test and chi-square test. Results The onset of sensory block in our study was earlier in Group B compared to Group A. In both groups, hemodynamic stability was maintained throughout the study. We recorded the onset/duration of sensory and motor block and hemodynamic changes and took mean values to find any significant difference. Postoperative complications and rescue analgesic requirements were monitored and managed and were a part of our study. Conclusions This study compared CSEA and SA regarding the severity and duration of sensory and motor block, hemodynamic stability, and associated complications in major lower limb orthopedic surgeries. The results shed light on the advantages and shortcomings of each anesthesia technique and, therefore, will help choose the correct method of anesthesia in a given surgery.