Comparison of thoracic vs lumbar spinal anaesthesia fo orthopaedic surgeries

摘要

Background: Thoracic spinal anaesthesia has emerged as one of the most promising anaesthetic techniques in the recent times. On the other hand, lumbar approach has been the conventional choice for orthopaedic surgeries since the advent of spinal anaesthesia. This study aimed at determining which approach is better suited for orthopaedic surgeries. Methods: Total 60 patients scheduled for orthopaedic surgeries were divided into two groups : group T and group L. Group T patients were given thoracic spinal anaesthesia at the T9-T10 / T10-T11 interspace using 1.5 ml of hyperbaric bupivacaine 0.5% (5 mg/ml) + 25μg (0.5 ml) of fentanyl. Group L patients received 2.5 ml of hyperbaric bupivacaine 0.5% (5 mg/ml) + 25 μg (0.5 ml) of fentanyl at LI-L2/L2-L3 interspace. Authors evaluated the degree of analgesia and motor block, haemodynamics and neurological complications. Results: Onset of analgesia was faster in thoracic group - 2min. The duration of sensory and motor block was shorter in thoracic group. There were no significant differences in haemodynamic variables and respiratory parameters between the two groups and no neurological complication in any patient. Conclusions: Thoracic spinal anaesthesia is preferable to lumbar spinal anaesthesia for orthopaedic surgeries.