Syed Asmat Ali, Harsha  Vardhan, Vivek  Pushp, 
    A Comparative Study of Spinal Versus General Anaesthesia in Elective Lower Limb Surgeries: Intraoperative Hemodynamic Stability and Postoperative Pain Outcomes,
    Research Journal of Medical Sciences,
    Volume 11,Issue 6,
    2017,
    Pages 229-234,
    ISSN 1815-9346,
    makrjms.2017.229.234,
    (https://makhillpublications.co/view-article.php?doi=makrjms.2017.229.234)
    Abstract: <p style="text-align:justify">Optimal anaesthetic technique in elective lower limb surgeries remains debated. Spinal anaesthesia may offer enhanced intraoperative stability and postoperative recovery compared to general anaesthesia. To compare intraoperative hemodynamic stability, postoperative pain scores, analgesic requirements and complication rates between spinal and general anaesthesia in patients undergoing elective lower limb surgeries. This prospective observational study was conducted at IQ City Medical College and Hospital, Durgapur, in 2017. A total of 200 adult patients (ASA I‐II) were allocated to receive either spinal (n=100) or general anaesthesia (n=100). Intraoperative mean arterial pressure (MAP), heart rate (HR), pain scores (VAS at 2, 6, 12, 24 hours), total analgesic consumption and adverse events were recorded and compared using appropriate statistical tests. Spinal anaesthesia provided greater MAP stability, with fewer hypotensive episodes (18% vs. 32%) and lower vaso pressor use (12% vs. 24%). Postoperative VAS scores were significantly lower in the spinal group at all intervals. Time to first rescue analgesia was longer (5.8&plusmn;1.7 vs. 3.2&plusmn;1.2 hours) and cumulative morphine use was reduced (4.8&plusmn;1.6 mg vs. 7.6&plusmn;2.2 mg). Adverse events including nausea, vomiting and delayed mobilization were less common with spinal anaesthesia. Spinal anaesthesia is associated with superior intraoperative hemodynamic control, better postoperative analgesia and a more favourable early recovery profile in elective lower limb surgeries compared to general anaesthesia.</p>

    Keywords: Spinal anaesthesia; general anaesthesia; lower limb surgery; hemodynamic stability; postoperative pain