Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Comparative Study of Sequential Combined Spinal Epidural Anaesthesia Versus Spinal Anaesthesia in High‐Risk Geriatric Patients for Major Orthopaedic Surgery: Government Medical College, Nizamabad, Telangana, India
Rodasi Chekka, Sujay Kumar Parasa and Kothuru Ramesh
Page: 309-313 | Received 25 Sep 2024, Published online: 26 Dec 2024
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Abstract
Sequential combined spinal epidural anaesthesia (Sequential CSEA) is a major advancement in central neuraxial blockade for high‐risk geriatric patients this decade since it combines the advantages of spinal and epidural anaesthesia while mitigating unfavourable effects. This study looks at the differences between spinal anaesthesia and sequential combination spinal epidural anaesthesia in older people who are likely to need major orthopaedic procedures. The study selected 80 geriatric individuals aged 65‐80 who were undergoing major elective orthopaedic surgeries. We randomly allocated the participants into two equal groups of 40 patients each, based on their ASA Grade I or II classifications. We conducted sequential CSEA on Group I (n=40) using 1 ml (5mg) of heavy bupivacaine and 20mcg of fentanyl in the subarachanoid space. To reach a T10 sensory level, a 0.5% isobaric bupivacaine epidural dose increase of 1.5‐2ml was given for each segment that wasn't blocked. This was done because the spinal block was expected to be incomplete. Spinal anaesthesia was delivered to Group II (n=40) with 2ml of 10mg% bupivacaine heavy and 20mcg of fentanyl. The P‐value was selected to evaluate the levels of significance. Significance was established at P<0.05. The mean age was 62.32±7.69 years in Group I and 68.32±3.28 years in Group II. No substantial age disparity existed between the groups. The disparity in the maximal sensory level attained by the two groups was significantly significant (P<0.001). The disparity in the initiation of total motor blockage (min) between the two groups was significantly significant (P<0.001). The average length of motor obstruction is statistically significant (P<0.001). The average duration till the peak of sensory analgesia is statistically significant (P<0.001). So sequential combined spinal epidural anaesthesia is a safe, effective and reliable technique with stable hemodynamic along with the provision of prolonging analgesia compared to spinal anaesthesia for high‐risk geriatric patients undergoing major orthopaedic surgery.
How to cite this article:
Rodasi Chekka, Sujay Kumar Parasa and Kothuru Ramesh. Comparative Study of Sequential Combined Spinal Epidural Anaesthesia Versus Spinal Anaesthesia in High‐Risk Geriatric Patients for Major Orthopaedic Surgery: Government Medical College, Nizamabad, Telangana, India.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.1.309.313
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.1.309.313