BACKGROUND Shivering is commonly encountered complication following spinal anaesthesia leading to discomfort and interference with monitoring during caesarean section. There is no definite aetiology for this and hence no definite treatment is available. Hence, we wanted to study effect of temperature variation of spinal inject on post spinal shivering during caesarean section. METHODS This prospective randomized double-blind study was conducted on 80 parturients posted for elective caesarean section allocated to two groups of 40 each receiving 2.0 mL of 0.5 % hyperbaric bupivacaine with temperature of 220 C (group I) or 370 C (group II) intrathecally at L3 - L4 interspace. Onset of shivering, its severity and incidence were noted. Data was analysed using various tests and P-value < 0.05 was considered as significant and P-value < 0.01 was considered highly significant. RESULTS Demographic characters, surgical parameters as well as onset time of sensory blockade, maximum sensory blockade, time to achieve maximum sensory and motor blockade were comparable in the two groups. Shivering was present in 57.5 % of patients in group I and 32.5 % in group II and this difference was statistically significant. Overall, shivering percentage was 45 % although difference in mean onset time was not significant in the two groups. Grades of shivering were comparable in both groups. CONCLUSIONS Warm solutions used intrathecally can reduce incidence of shivering following spinal anaesthesia in caesarean section although it doesn’t influence intensity of shivering. KEY WORDS Neuraxial Anaesthesia, Temperature Variation, Post Spinal Shivering
BACKGROUND The aim of the study is to compare the effects of intrathecal levobupivacaine-fentanyl and levobupivacaine on quality of intrathecal/subarachnoid block and haemodynamic variations in caesarean deliveries. MATERIALS AND METHODS The study was designed as a prospective randomised double-blind study enrolling a total of 60 female patients (age group-20-40 years) belonging to ASA grade I and II. The patients were randomly allocated into two groups of 30 patients in each group. The Group-LF received levobupivacaine 10 mg (2 mL) + fentanyl 20 mcg (0.4 mL) and Group-LN received levobupivacaine 10 mg (2 mL) + normal saline (0.4 mL). Characteristics of spinal block, Apgar score, vital parameter variations and complications were recorded. RESULTS In Group LF, onset of action was faster in relation to sensory and motor blockade as compared to Group LN. Two segment regression of sensory block and duration of motor block were prolonged with addition of fentanyl to levobupivacaine. Addition of fentanyl to intrathecal levobupivacaine, prolonged duration of sensory and motor block with faster onset of sensory and motor block with better quality as compared to levobupivacaine. Statistically, no significant difference was observed in mean Apgar score at 1 and 5 minutes. There was no much difference between the groups in relation to haemodynamic variations and complications. CONCLUSION Intrathecal levobupivacaine with fentanyl was found to improve the quality and prolonged duration of intrathecal block. It reduced the need for rescue analgesia/supplementary analgesics for postoperative pain relief without any significant side effects. The levobupivacaine with or without fentanyl maybe used safely for spinal anaesthesia in elective caesarean deliveries.
Background And Aims: Parturients posted for LSCS present with physiological changes due to pregnancy and gravid uterus, may have associated co-morbidities, superadded by COVID 19 infection poses a real challenge for an anesthesiologist. Urgency in obstetric anesthesia and extreme precautions needed to avoid this contagious disease further increase the burden on the anesthesiologist. This study focuses on perioperative presentation, management, and outcome of patients in a tertiary level hospital. Method: 329 pregnant females with RAT or RTPCR positive for COVID 19 and undergoing cesarean section from 1st May 2020 to 31st July 2021 were included in this retrospective observational study. Data was collected and analyzed from OT, ICU, WARD records, patient medical and electronic records, and maternal mortality data. Results: Amongst 329 parturients, 98.48%(324/329) received spinal anesthesia, one received epidural anesthesia (0.30%) and 1.21%(4/329) required general anesthesia. The incidence of hypotension was 5.77% (19/329), managed with inj. Mephentermine without inotropes. The intraoperative course was uneventful except for one case of CRA, revived successfully. Nine patients (2.73%) required ICU care. Oxygen support by either nasal prongs or face masks was given to 3.95% (13/329) patients. Three patients (0.91%) required NIV support and three patients (0.91%) required invasive ventilation postoperatively. The overall mortality was 0.61% (2/329). The mean duration of hospital stay was found to be 8.2 ± 5.03 days Conclusion: Neuraxial anesthesia remains a technique of choice for LSCS and can be safely employed in the parturients even with moderate pneumonia. General anesthesia can be reserved for patients of severe covid pneumonia.
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