Medicinski vjesnik, Vol. 48 No. (1-2), 2016.
Original scientific paper
Comparison of Perioperative Adverse Effects of Bilateral and Unilateral Spinal Anaesthesia
Luka Đulabić
Višnja Nesek Adam
Katarina Šakić
Maja Karaman Ilić
Ivan Šklebar
Abstract
Hemodynamic changes during spinal anaesthesia are directly related to the size of sympathetic blockade. In contrast to standard bilateral spinal anaesthesia, unilateral spinal anaesthesia may restrict sympathetic block and avoid undesired effects. The purpose of this study was to compare the incidence of adverse effects between unilateral and bilateral spinal anaesthesia. The study included 52 patients with ASA status I and II scheduled for elective surgery under spinal anaesthesia
at Department of Anaesthesiology, Resuscitation and Intensive Care, and Department of Surgery of University Hospital “Sveti Duh” in Zagreb, Croatia. The patients were randomly divided in two groups. Patients in the US group (n = 26) underwent unilateral spinal anaesthesia with hyperbaric anaesthetic solution (5 mg of 0.5% levobupivacaine, 50 μg fentanyl, and 1 mL of 10% glucose). Patients in the BS group (n = 26) received bilateral spinal anaesthesia with 3 mL isobaric 0.5% levobupivacaine (15 mg). Adverse effects such as headache, nausea, vomiting, urinary retention, regression of motor block, and first time of getting out of bed were surveyed postoperatively. During anaesthesia, adverse effects such as hypotension and bradycardia were also recorded. The time needed to return muscle strength (2.9 ± 1.1 h vs. 4.2 ± 1.4 h, p < 0.001) and time elapsed before getting out of bed for the first time (9.9 ± 7.2vs. 19.8 ± 6.9 h, p < 0.001) was shorter in the unilateral group of patients than in bilateral group of patients. The incidence of urinary retention was lower (2 vs. 9, p = 0.017) and level of satisfaction was higher (20 vs. 13, p = 0.044) in the US group of patients.
In conclusion, unilateral spinal anaesthesia reduces the incidence of disturbances of micturition and is associated with faster recovery and greater patient satisfaction than the standard bilateral spinal anaesthesia.
Keywords
Anaesthesia, spinal – adverse effect, methods, statistics & numerical data; Anesthetics; Hypotension; Bradycardia
Hrčak ID:
224416
URI
Publication date:
19.12.2016.
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