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Category: Volume 09 Issue 06 June 2021
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Title: Spinal Anaesthesia Using Taylors Lumbosacral Approach to Reduce the Incidence and Severity of Haemodynamic Side Effects in Patients Undergoing Transurethral Resection of Prostate

Authors: Dr Kamini Randhawa, Dr Shweta Mahajan, Dr Arti Sharma

 DOI: https://dx.doi.org/10.18535/jmscr/v9i6.41

Abstract

Hemodynamic side effect like bradycardia and hypotension are the most common undesired side effects during spinal anaesthesia. In1940 Taylor described a SPA technique by a lumbosacral approach which caused less haemodynamic disturbances. The purpose of the present study was to compare the incidence and severity of haemodynamic side effects between a lumbar approach at L4/5 or Taylor’s lumbosacral approach. 30 patients received SPA by a L4/5 approach and 30 patients by Taylor’s approach.

Bupivacaine dose did not differ between groups. Onset of MLSB was faster (3.17+1.020 min vs 7.20+1.215, p <0.001) in the lumbar group. Onset of motor block was faster (5.47+1.358 min vs 8.40+0.770) in lumbar group but duration of motor block did not differ between groups. The maximum decrease in heart rate was greater in lumbar group (27% vs 7%, p value 0.019). The maximum decrease in mean arterial pressure was also greater in the lumbar group (60% vs. 70%, p value 0.037). SPA with plain bupivacaine using Taylor’s approach was associated with slower onset of MLSB and less haemodynamic disturbances compared to the classical lumbar approach at L4/5.

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Corresponding Author

Dr Kamini Randhawa

Junior Resident, Department of Anaesthesiology, Indira Gandhi Medical College, Shimla