COMBINED GENERAL AND THORACIC EPIDURAL ANAESTHESIA WITH LEVOBUPIVACAINE 0.5% VERSUS GENERAL ANAESTHESIA FOR UPPER ABDOMINAL SURGERIES : A COMPARATIVE STUDY

SINGH NEELAM; RAW B.K.; MISHRA L.S.; RAGHAVENDRA V

Volume : V, Issue : III, March - 2016

COMBINED GENERAL AND THORACIC EPIDURAL ANAESTHESIA WITH LEVOBUPIVACAINE 0.5% VERSUS GENERAL ANAESTHESIA FOR UPPER ABDOMINAL SURGERIES : A COMPARATIVE STUDY

Singh Neelam, Raw B. K. , Mishra L. S. , Raghavendra V

Abstract :

Aim: The purpose of our study was to compare the stress response to surgery for patients undergoing elective major upper abdominal surgeries by giving combined general and thoracic epidural anaesthesia versus general anaesthesia alone. Methods: Study was a prospective, double–blinded, randomized controlled study. Conducted on 60 patients, 30 in each group. Group A: combined general and thoracic epidural anaesthesia and Group B: Patients received general anaesthesia alone. Stress response surgery in perioperative period assessed by hemodynamic parameters such as pulse rate, blood pressure [NIBP] biochemical parameters such as serum cortisol, blood glucose and effect on tissue oxygen saturation by measuring pO2 in each case of both groups. Results: There was no statistically significant difference between the groups with respect to age, weight and gender (�p� >0.05).Decreased serum cortisol, blood glucose and increase in tissue oxygenation (pO2) levels in intra and post–operative periods in group A compared with group B, (�p� <0.05) and regarding intra and post–operative hemodynamic tachycardia and hypertension were more common in group B compared with group A (�p� <0.05). Conclusion: Combination of general anesthesia with thoracic epidural anaesthesia provides a better intra–operative and post–operative hemodynamic stability relative to general anesthesia alone and decreased stress response to surgery, achieved a better analgesia and attenuate the physiologic response to surgery.