COMBINED THORACIC EPIDURAL AND LIGHT GENERAL ANAESTHESIA FOR UPPER ABDOMINAL SURGERY IN HIGH RISK PATIENTS
SABAHAT TARIQ, NIGHAT ABBAS, AKHTAR WAHEED KHAN,
NADEEM NAQVI, GHULAM MURTAZA
ABSTRACT
OBJECTIVE: The goal of the study was to assess the safety and effectiveness of the thoracic epidural anesthesia (TEA) in high risk patients undergoing upper abdominal surgery.
STUDY DESIGN: Quasi Experimental.
PLACE AND DURATION OF STUDY: Department of anaesthesia, Liaquat National Hospital, Karachi from August 2002 - July 2003.
PATIENTS AND METHODS: 20 adult patients aged between 50 - 70 years were selected with ASA status III and IV. TEA was performed in sitting position at the level of T7 - T8 using hanging drop method. Titrated doses of 0.25%, Bupivacaine and 1% Xylocaine was injected 1 ml / dermatome through the catheter, anesthetic levels achieved were found to be T4 - T10.
Light general anesthesia was instituted by using I/V propofol 50 - 60 mg, I/V Nalbuphine 5 - 7.5 mg & Midazolam 1.5 - 2 mg I/V.
Total dose of local anesthetic varied of local anesthetic varied from 12 - 18 ml (mean 16 ml). Two patients had bradycardia with heard rate less than 60 beast/ min treated with atropine. Two patients had hypotension treated with titrated doses of ephedrine and I/V Rinter's solution.
|