Practice of Unilateral Spinal Anesthesia During Varicose Lower Limb Surgery in Morafeno University Hospital Toamasina

Marie Osé Judicael HARIOLY NIRINA, Toky Rafanomezantsoa, Josoa Andrianiaina RAKOTOARISOA, Maximin Totoamby, Nicole Cathérine Rakotoarison, Andry Mampionona Riel, Andriambelo Tovohery Rajaonera

Abstract


Introduction: To our knowledge, unilateral spinal anesthesia in the Atsinanana region of Madagascar has not been studied to date. Our study aims were mainly to describe our current practice in performing unilateral spinal anesthesia during varicose surgery of the lower limb and secondarily to assess the factors influencing success of the technique.

Methods and Patients: This is a prospective, observational, descriptive and analytic non-randomized, single-center study over a period of 18 months, including all patients requiring lower limb surgery.

Result: Forty-two (42) patients were selected for our study. The mean age of our study population was 47.5 ± 19.82 years with extremes of 16 to 86 years. The average installation time of the blocks was 14.5 ± 2.87 minutes with the extremes of 13 to 30 minutes. The average regression time of the blocks was 125.26 ± 32.24 minutes with the extremes of 15 to 180 minutes. The types of intervention were crossectomy with stripping, phlebectomy and stripping. The failures concerned bilateralisation, early regression and absence of sensory block. The success rate of anesthesia was 85.6%. The dose of hyperbaric bupivacaine and patient positioning had a significant impact on the success rate of anesthesia.

Conclusion: Although it is a simple technique, an effort in drafting a protocol to standardize the practitioner attitude still needs to be provided in order to improve the effectiveness rate.


Keywords


unilateral spinal anesthesia, varicose vein surgery, hyperbaric bupivacaine.

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