الفهرس 
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Abstract
Summary
There has been a significant increase in the use of spinal anaesthetic for lower limb surgeries in recent years. An effective IT agent for lower-extremity surgery should meet certain criteria. The first need is that it shows that motor and sensory blockage is quickly initiated. Second, these effects should reverse in a predictable fashion within a reasonably quick time period. Finally, the agent should have few unintended consequences. The benefits of regional anesthetic for lower limb procedures include less blood loss, a lower incidence of venous thromboembolism, a lower metabolic stress response to surgery, and a lower risk of pulmonary compromise. A common side effect of spinal anesthesia is the paralysis of sensory, motor, and autonomic nerves.
Bupivacaine, a long-acting local anesthetic in the amide group, has a low incidence of TNS when administered during hyperbaric therapy, which is a medical treatment involving the injection of 100% oxygen at hyperbaric pressures. The pharmacological profile of the local anesthetic is what sets it apart from its short-acting rivals, and it is responsible for the prolonged recovery of motor and sensory blocks. Urinary retention after surgery is more common when long-acting local anesthetics such bupivacaine are used rather than their shorter-acting counterparts.
It has been reported that modest dosages (between 5 and 10 mg) of bupivacaine administered alone may provide effective spinal anesthesia in outpatient settings. Urinary retention continued to affect anywhere from 3.7% of the population to 16%. In addition, the height of the blockage is not known when very low dosages are used, increasing the risk of the blockage failing. When given spinally, prilocaine has a modest duration of effect and is therefore categorized as an amide-type local anesthetic. Local anesthetic prilocaine has just been made available again after being taken off the market. The hyperbaric version of this chemical is easily accessible, and after spinal delivery, it may keep a patient unconscious for up to 90 minutes.
Because of its shorter recovery time compared to hyperbaric bupivacaine, hyperbaric prilocaine 2% is increasingly being used for spinal anesthetic in the ambulatory setting.
Our present investigation’s results may be summed up in a few key points:
This research found no statistically significant variations in patient characteristics or surgical data between the two groups compared. Included in this category are variables such as patient age, gender, BMI, ASA classification, and surgical procedure and duration. The p-value was higher than 0.05, hence there were no statistically significant differences between the groups.
Time to commencement of sensory block, time to onset of motor block (in minutes), time to maximal sensory block level (in minutes), and time to preparation for surgery were all significantly shorter in the Prilocaine group compared to the Bupivacaine Group.
The maximal degree of sensory block (dermatome) did not vary significantly between the Prilocaine group and the Bupivacaine Group.
Results showed that the Prilocaine group had significantly worse post-operative results than the Bupivacaine Group. Time spent sitting, standing, walking alone, and urinating on one’s own all decreased significantly, and this trend held true across all measures of sensory and motor block length.
The results of this research show that patients given prilocaine spent much less time in the PACU and were sent to home sooner than those given bupivacaine.
Our research showed that the VAS scores of the Prilocaine group and the Bupivacaine group were statistically indistinguishable.
Overall fluid volume administered during surgery, average HR, and MAP recorded intraoperatively and postoperatively at various time intervals showed no statistically significant difference between the two groups studied in this study. There was no discernible difference between the two groups in terms of the necessity for intraoperative sedation or postoperative pain medication.
The results of this research showed that there was no statistically significant difference in the occurrence of TNS and other postoperative complications in the Prilocaine group and the Bupivacaine Group.