Current Sedation Practices in Procedures under Spinal Anaesthesia (SA)

Abstract

Introduction: Peri-operative anxiety and stress associated with procedures under Spinal anaesthesia (SA) is common and sedation may help improving compliance of the patient and quality of SA. There is no standard sedation protocol for SA. Study aimed to observe the various sedation protocols practiced in our institute during SA with regard to drugs used and their dosages, sedation levels, effect on the duration of SA and to assess the patient satisfaction level. Material and methods:This was a prospective observational study comprised of patients undergoing elective surgeries under SA. IV sedation was given as per the attending anaesthesiologist's discretion after SA. We noted hemodynamic parameters, RSS, two-dermatomal regression time, Patient satisfaction scores etc. Epi Info 7.2 software was used for statistical analysis. Results Total 500 patients received Dexmedetomidine (189), Midazolam (301) and Propofol (10) as IV sedation. Mean time required for regression of two-dermatomal sensory levels and for rescue analgesia requirement was prolonged in Dexmedetomidine (121.64, 203.75 mins resp.), as compared to Midazolam and Propofol. Mean Ramsay Sedation Score (2.4-3) and Patient satisfaction scores (6-7.5) were comparable in all the drugs. Hemodynamic parameters were stable and comparable. No hypotension, respiratory depression seen except bradycardia (HR<50) noted in 4 patients of Dexmedetomidine. Conclusion: Drugs used for sedation in 500 patients were Dexmedetomidine, Midazolam and Propofol. All the drugs provided optimum sedation without respiratory depression with stable hemodynamics and good patient satisfaction. In addition, Dexmedetomidine increased durations of sensory anaesthesia and post-operative analgesia.

Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

“…The time required for sedation onset and recovery is much faster with propofol compared to midazolam under spinal anesthesia. 6,7 The patient's clinical response can be assessed through a sedation score, one of which is the Modified Ramsay Sedation Scale (RSS). The RSS assessment is from a score of 0 to 6, where a score of 0 is paralysis and cannot be evaluated, a score of 1 patient is conscious, a score of 2 patients is in light sedation, a score of 3 patients is moderately sedated and a response to a non-pain stimulus, a score of 4 patients is moderately sedated and responds.…”

Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

“…for pain stimuli, This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License propofol than midazolam for sedation during spinal anesthesia. 6,7 Prior to performing thoracal spinal anesthesia, all patients were monitored with non-invasive blood pressure, oxygen saturation, and all monitored data were recorded at 5 minute intervals. Abucath no 20 placed on the left hand for rehydration and drug administration.…”

Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

“…propofol than midazolam for sedation during spinal anesthesia. 6,7 Prior to performing thoracal spinal anesthesia, all patients were monitored with non-invasive blood pressure, oxygen saturation, and all monitored data were recorded at 5 minute intervals. Abucath no 20 placed on the left hand for rehydration and drug administration.…”