LOWER THORACIC SPINE SURGERIES UNDER SPINAL ANESTHESIA: A NOVEL INITIATIVE
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Keywords
Lower thoracic spine surgeries, spinal anaesthesia, Bupivacaine, Fentanyl, Tramadol, VAS, Postoperative analgesia
Abstract
Spinal anesthesia is a safe and effective alternative to general anesthesia for patients undergoing lumbar spine surgery, and numerous reports have demonstrated its advantages. Aim: To compare the efficacy of intrathecal tramadol and fentanyl as adjuvants to bupivacaine in lower thoracic spine surgeries. Methods: The study was carried out in the Department of Anesthesiology at Government Medical College (GMC) Anantnag. The study included 60 patients who were equally divided into two groups, Group T (tramadol-bupivacaine) and Group F (fentanyl-bupivacaine), to compare the efficacy of intrathecal tramadol and fentanyl as adjuvants to bupivacaine in lower thoracic spine surgeries. Group-F received 0.5% bupivacaine heavy 3 ml (15 mg) + fentanyl 0.5 ml (25 μg) intrathecally, and Group-T received 0.5% bupivacaine heavy 3 ml (15 mg) + tramadol 0.5 ml (25 mg) intrathecally. Both groups were observed for characteristics of motor and sensory blockade, hemodynamic parameters, and perioperative complications. Patients were monitored for a Ramsay score for sedation, a VAS score for pain, and the time required for post operative analgesia. Results: The onset of sensory blockade was significantly faster in Group F (4.5 ± 0.9 minutes) compared to Group T (6.3 ± 1.1 minutes, p < 0.001). Similarly, the onset of motor blockade was significantly earlier in Group F (5.1 ± 1.0 minutes) than in Group T (7.2 ± 1.3 minutes, p < 0.001). The duration of sensory blockade was significantly longer in Group F (233.4 ± 18.6 minutes) compared to Group T (210.5 ± 17.4 minutes, p < 0.001). Likewise, the duration of motor blockade was significantly prolonged in Group F (180.2 ± 15.3 minutes) compared to Group T (162.7 ± 14.2 minutes, p < 0.001). The duration of postoperative analgesia, which is a crucial factor in pain management, was also significantly greater in Group F (340.1 ± 25.7 minutes) than in Group T (280.3 ± 22.6 minutes, p = 0.002). Conclusion: This study found that fentanyl demonstrated a significantly faster onset and longer duration of both sensory and motor blockade compared to tramadol. Additionally, fentanyl provided superior postoperative analgesia with fewer adverse effects, particularly nausea and vomiting.
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Dr. Mehak Shabir
Postgraduate Scholar, Department of Anaesthesiology and Critical Care, Government Medical College Anantnag, India
Dr.Younis Kamal
Associate Professor and Head, Department of Orthopedics, Government Medical College Anantnag, India.
Dr. Anjum Shamim
Associate Professor and Head, Department of Anesthesiology and Critical Care, Government Medical College Anantnag, India.
Dr. Wasim Salman
Associate Professor and Head, Department of Anesthesiology and Critical Care, Government Medical College Baramulla, India.
