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SPINAL ANAESTHESIA WITH FINE NEEDLE 27G IN YOUNG PATIENTS UNDERGOING ORTHOPEDIC SURGERY.



Abstract

Aim: Our aim was to record our experience with a fine needle 27G with any possible difficulties and side-effects.

Methods: 38 patients (26 men, 12 women) were selected for our study, aged 18–33 years. The underwent orthopedic surgery (femoral fractures, ankle surgery, patella, tibia and fibula fractures). The patients were preloaded with 500–700 ml crystalloid fluids.Lignocaine 2% (2–4ml) was injected for skin infiltration.

The spinal was performed in lateral positioning in O3–O4 or O4–O5 spaces. Bupivacaine (Marcaine 0.5%) was injected and clonidine (Catapresan) was added in 8 cases for prolonged anaesthesia. The injection was slow and the patients were evaluated in 1, 12, 24, 48 hours.

Results: Headache – technical difficulties – delayed action – nausea and vomiting and urine retention were recorded.

Headache. Even though all the patients were well informed for 24th bed rest, 2 of them suffered headache. They were treated with fluids, paracetamol, bed rest. No headache was noted after 72 hours.

Technical difficulties. Multiple tries were needed for successful spinal in 3 obese patients.

Delayed action. In 4 cases the onset of spinal anaesthesia took more than 20min. One patient was finally given general anaesthesia because of the spinal failure.

No urine retention was recorded.

Nausea – vomiting. 3 patients suffered nausea and were given ondasertron. No vomiting was recorded.

Conclusion: We conclude that spinal anaesthesia in young patients doesn’t cause severe side-effects nor technical difficulties. Headache, nausea, vomiting are less common in spinal than general anaesthesia.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.