Background: To study the efficacy of spinal analgesia with low concentration bupivacaine for anorectal surgery as compared to low dose bupivacaine epidural analgesia. Methods: This randomized control study was conducted on 60 adult patients undergoing elective anorectal surgery. The patients were randomly allocated into one of three groups of 20 patient’s each. The two treatment arms received s...

BACKGROUND Previous studies have shown that if performed without radiographic guidance, the loss of resistance (LOR) technique can result in inaccurate needle placement in up to 30% of lumbar epidural blocks. To date, no study has shown the efficacy of measuring the depth of the posterior complex (ligamentum flavum, epidural space, and posterior dura) ultrasonographically to distinguish true an...

Too OFTEN, before she even meets the anaesthetist, the woman in labour has already experienced the greatest part of the pain associated with having her baby. She then receives an epidural block, a saddle block, or other form of anaesthetic for the final half hour or so of labour. The first stage is often a trying, unpleasant, and painful episode. In the past this has been dealt with relatively ...

BACKGROUND Perioperative intestinal hypoperfusion is a major contributing factor leading to organ dysfunction. It can be caused by stress as a result of surgical manipulation or hypoxia. Additionally, anaesthesia can affect intestinal oxygenation. This animal study was designed to assess the effects of reduced regional sympathetic nervous activity induced by thoracic epidural anaesthesia on int...

Until recently epidural abscess was considered a rare, almost theoretical, complication of central nerve block, but anecdotal reports suggest that this is no longer the case. Thus a review of the risk factors, pathogenesis, clinical features and outcome of this condition is appropriate, the primary aim being to make recommendations on best anaesthetic practice to minimize the risk of this serio...

Sacral hiatus is caudal opening of sacral canal. Caudal epidural anaesthesia for various therapeutic and diagnostic procedures is administered through sacral hiatus. 25% failure rate of caudal epidural block has been reported in literature. The failure rate of this procedure may be due to variant anatomical features of sacral hiatus. Hence knowing the anatomical variations in shape, size, level...

Several complications are possible after a lumbar epidural block. However pneumocephalus are rare. In this case, we report a case of pneumocephalus. A 68-year-old male patient received lumbar epidural block with the loss of resistance technique using air, and after 35 minutes, apnea, unconsciousness, hypotension, and bradycardia occurred. Immediately, brain CT was done, and we found pneumocepha...

The effect of pH-adjustment of three per cent 2-chloroprocaine (2-CP, Nesacaine MPF) on the onset, duration, and spread of epidural analgesia and anaesthesia was studied in patients undergoing lower extremity surgery. Forty ASA physical status I and II patients were randomized to two groups. In a double-blinded fashion, patients in both groups received an epidural injection of 15 ml of local an...

Forty-five patients received lumbar epidural block for major vaginal surgery. Twentyfive of them had, in addition,', light general anaesthesia (halothane, oxygen and spontaneous respiration). Measurements of blood loss and mean (integral) operative blood pressure were made. The group receiving halothane had a significantly lower mean integral operative blood pressure dian the group receiving lu...

Neuraxial anesthesia is a term that denotes all forms of central blocks, involving the spinal, epidural, and caudal spaces. Epidural anesthesia is a versatile technique widely used in anesthetic practice. Its potential to decrease postoperative morbidity and mortality has been demonstrated by numerous studies. To maximize its perioperative benefits while minimizing potential adverse outcomes, t...