EVALUATION OF EPIDURAL PHENYLEPHRINE ON THE HEMODYNAMICS INDUCED BY ALKALINIZED LIGNOCAINE EPIDURAL ANESTHESIA

Dr. D. Sivakanth, Dr. Ravi

Abstract


Introduction:

                        Epidural  bupivacaine and lignocaine has been studied extensively in the past,the use of both local anesthetic in neuraxial anesthesia is associated with hypotension if used in higher concentration and volumes.Alpha adrenergic agonist have been used as an adjuvant to epidural local anesthetic to improve the quality of analgesia after major abdominal surgeries.Hence we studied the hemodynamic changes associated with phenylephrine in Epidural  lignocaine anesthesia.

MATERIALS AND METHOD :  A prospective randomised case control study done after obtaining ethical committe clearance and written informed consent of 60 adult patients ,15 patients in each group admitted in Tanjavur medical college hospital for below umbilical surgery.Patients were randomly divided into four groups, namely group 1 Lignocaine 2% 17 ml with 3ml of sodabicarbonate with 0.5ml of distilled water,group 2 Lignocaine 2% 17 ml with 3 ml of sodabicarbonate with 0.5 ml of 50 mics phenylephrine,group 3 Lignocaine 2% 17 ml with 3 ml of sodabicarbonate with 0.5ml of 100micsphenylephrine, group 4 Lignocaine 2% 17ml with 3 ml of sodabicarbonate with 0.5ml of 200 mics phenylephrine, and compared.

RESULTS: We found statistically significant difference between all groups 1-4,using one way ANOVA.There is a significant difference between group 4 and all other groups in heart rate and mean . blood pressure.There is is asignificant reduction in ephedrine dose in group 4 when compared to other groups.

CONCLUSION:We conclude phenylephrine in a dose of 10 mics/ml of local anesthetic epidurally produces marked hemodynamic stability and decreases the use of vasopressors.


Keywords


Epidural phenylephrine, hemodynamic stability

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