Continuous spinal anesthesia for selective spinal block in lower limb surgery

Document Type : Original Article

Authors

1 anesthesia and surgical ICU , faculty of medecine , zagazig university , zagazig , sharkia

2 anesthesia and surgical ICU ,faculty of medecine , zagazig university , zagazig , sharkia

3 anesthesia and surgical intensive care, fculty of medicine, zagazig universiy, Al Sharkya, Egypt

Abstract

Background: Continuous spinal anesthesia (CSA) is a reliable method for providing effective anesthesia and offers considerable advantages over ‘single-shot’ spinal anesthesia (SSSA), as it provides a well-controlled anesthesia using small doses of local anesthetics.
Objective: To compare the effectiveness and safety of CSA to get a selective spinal block in lower limb surgery and to assess the complications following the technique compared to single shot technique.
Methods: This study was a prospective randomized double blinded controlled clinical trial , conducted in Zagazig University Hospitals. Sixty both sexes patients of American Society of Anesthesiology physical status class I–II and undergoing unilateral lower limb elective surgeries were enrolled in this study during the period from Jan 2016 to Jan 2018. According to the used technique for establishment of selective spinal block, these patients were randomly allocated into two groups: one received CSA using epidural catheter ( CSA group ), and the other group received single shot spinal anesthesia (SSSA group).
Results: There was more hemodynamic stability in CSA group rather than SSSA group . The need for general anesthesia supplementation was higher in SSSA group than the CSA group. PDPH was more frequent and more severe in CSA group . No patient in our study developed motor loss , sensory loss or cauda equine syndrome .
Conclusion: We conclude that Continuous spinal anesthesia is an effective and safe choice with good hemodynamic stability and a high degree of success, for unilateral lower limb surgeries specially when haemodynamic stability is a concern.

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