ABSTRACT

Aim: To compare the effects of 7.5mg versus 4mg of 0.75 bupivacaine in saddle block for perineal surgery on motor blocked.

Study Design: Randomized controlled trial

Place and duration of study: Operations Theatres of Jinnah Hospital Lahore from 1st March 2009 to 31st March 2010.

Methodology: One hundred patients were included and divided into Group A and group B received 4 mg and 7.5 mg hyperbaric bupivacaine intrathecally respectively in sitting position at the level of below L2-L3. Patient’s blood pressure was noted every two minutes for 10 minutes and later on every five minutes interval during surgery.

Results: Grade I motor blockade was found in 36(72%) in group A while in group B only 7(14%) patients with statistically significant (P<0.05). Grade II motor blocked was found in 11(22%) patients in group A and 19 (38%) in group B. Grade III motor blocked found in 3(6%) patients of group A while 21(42%) in group B with statistically significant (P<0.05). No patients with grade IV motor blocked in group A while 3(6%) in group B and there was no significant difference in hemodynamic changes in both groups. All patients remained pain free in both groups.

Conclusion: 4 mg of 0.75% hyperbaric bupivacaine produces significantly less motor blocked as compared to 7.5 mg while no significant hemodyamic change.

Keywords: Perineal surgery, Saddle block, Spinal anesthesia, Motor blockade, Hemodynamic changes