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Category: Volume 08 Issue 01 January 2020
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Title: Combined General Anaesthesia and Spinal Anaesthesia versus General Anaesthesia only in total Laparascopic Hysterectomy- A Comparative Study

Authors: Pradipta Kumar Patel, Dulal Kishun Soren, Subhadipta Panigrahi, Pujarini Beuria

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.105

Abstract

Background and Objectives: Spinal anaesthesia was combined with general anaesthesia for achieving hemodynamic stability in laparoscopic hysterectomy. The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anaesthetics, vasodilators.

Material and Methods: We conducted a prospective randomized study in ASAI/II patients posted for laparoscopic hysterectomy, after taking proper written consent. Patients were randomly assigned to receive SA with GA (group SGA) or plain GA (group GA).Group SGA received 10 mg of 0.5% Bupivacaine (heavy) for SA. GA was administerd using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators and surgeon satisfaction were also studied.

Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to GA was statistically significant (p<0.01). Group GA showed additional requirement of Nitroglycerine infusion and higher concentration of isoflourane. Group SGA showed greater surgeon satisfaction as compared to group GA.

Conclusion: The hemodynamic repercussions during pneumoperitoneum can be effectively attenuated by combining SA and GA, without any adverse effects.

Keywords: General anaesthesia, hemodynamics, laparoscopy, pneumoperitoneum, spinal anaesthesia.

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Corresponding Author

Subhadipta Panigrahi

Junior Resident, Department of Anaesthesiology, VIMSAR