radical mastectomy under spinal anaesthesia embedded video
TRANSCRIPT
Introduction
• Practicing this technique since last 15 years.
• Study of 350 cases till date
• Age group- 30-80 yrs. (ASA I to IV )
Technique
• Preloading with crystalloids, inj. Rantac & inj. Zofer
• Same as Spinal Anaesthesia
• L3-L4 interspace
• Drug: Sensorcaine (Heavy) 0.5%
• Quantity of drug: 2.5-3 ml
• Needle no. 27 (LP needle)
• No additional analgesia or additives required
• Mild sedation may be used in anxious or apprehensive patients.
Complications
• Bradycardia
• Hypotension
• Post spinal headache
• Missing Dermatome 11% 10%
1%1%
76%
Complications PercentageBradycardia (<60) Hypotension (< 70)Post spinal headache Dermatomae missingNo Cognizeble side effects
Advantages
• No extra skill required• Can be practiced at periphery with ease • No absolute contraindications except those unfit for
routine spinal anaesthesia.• Bilaterally effective single dose • Reduced complications during and after the surgery• Decreased morbidity• Prolonged analgesia• No incidence of high spinal• Cost efficacy
What is different?
• Tilt (30-35 D head low position)
• Slow administration of the drug ( >2 min)
• Level of analgesia/ anaesthesia upto T2
Case Studies
Case 1
• 44 years old female, ASA II• Posted for left radical mastectomy
Case1_video
Case 2
• 62 year old female, ASA II• Posted for left radical mastectomy
Case2 Video
Case 3
• 38 year old female, ASA II• Posted for left radical mastectomy
Case3 Video