Response of unilateral spinal anaesthesia in elderly patients admitted to BMC & Allied Teaching Hospital in District BANNU-KPK.

Abstract

Objectives: The objective of this study was to investigate the possible restriction effects of unilateral spinal anaesthesia on sympathetic block to evade unwanted cardiac effects in elderly patients. Study Design: Cross section study. Setting: Department of Surgery, BMC Allied Teaching Hospitals District Bannu-KPK. Period: June 2018 to January 2020. Material & Methods: In this study, 30 ASA III and ASA IV male adults having an age 55-65 and receiving lower limb surgery were included. The patients were given unilateral spinal anaesthesia (using 0.5% Bupivacaine). All the subjects were maintained in a lateral position having their operated side downwards and were kept in position for a period of 15 minutes. The assessment of the sensory and motor nerves was done, and hemodynamic changes were recorded following spinal anaesthesia. The monitoring was done for half an hour. Results: The observed hemodynamic effects in elderly patients were minimum which demonstrated the effectiveness of unilateral spinal anaesthesia in limiting the sympathetic block, evading the unwanted cardiac effects thus providing high cardiovascular stability. It was observed that the preparation time required for unilateral spinal anaesthesia was a bit longer as compared to conventional method. The technique also proved to be acceptable for patients with an elevated autonomy following surgical procedure and lesser urine retention. Conclusion: When unilateral spinal anaesthesia was administered in admitted patients using lower flow injection method and low volume, stable hemodynamic results were achieved. Patients were more satisfactory. Thus, unilateral spinal anaesthesia is effective in limiting the sympathetic block in old age patients.