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Unilateral Spinal vs General Anaesthesia in Low EF Patients: A Hemodynamic Comparison
Sponsor: Sargodha Medical College
Summary
A difference exists in intraoperative hemodynamic stability and vasopressor requirement between the two techniques
Official title: Comparison Between Unilateral Spinal Anaesthesia and General Anaesthesia in Patients With Reduced Ejection Fraction (35-40%) Undergoing Lower Limb Surgery in Terms of Intraoperative Hemodynamic Stability
Key Details
Gender
All
Age Range
18 Years - 70 Years
Study Type
OBSERVATIONAL
Enrollment
78
Start Date
2026-07-05
Completion Date
2026-12
Last Updated
2026-08-10
Healthy Volunteers
No
Conditions
Interventions
Unilateral spinal anesthesia
Patients (Selected for Unilateral Spinal Anaesthesia, UniSA) will be positioned laterally with the operative side dependent. Following aseptic preparation, Patient will be given a small volume of preload of Ringer Lactate (3-5ml /kg) i.e 250-300ml to avoid Spinal induced hypotension and to minimize fluid overload due to reduced ejection fraction. After giving preload, A 25-gauge Quincke needle will be introduced at the L3-L4 interspace, and 1.0 ml (7.5 mg) of 0.75% hyperbaric bupivacaine will be injected intrathecal. The lateral position will be maintained for approximately 10 minutes to achieve a unilateral block. Analgesia will also be maintained by using Ketorolac and Acetaminophen if there would be any complain of Pain. Continuous monitoring of HR, MAP, and SpO₂ will be undertaken to ensure stability
General anesthesia
Anaesthesia induction will be achieved with IV propofol (1-2 mg/kg) and nalbuphine (0.1 mg/kg) for analgesia. Neuromuscular relaxation will be achieved with atracurium (0.5 mg/kg) and additional doses will be given as needed. Anaesthesia will be maintained with isoflurane in a mix of oxygen and air. If the heart rate or mean arterial pressure rises by more than 20% from baseline, an extra dose of nalbuphine (2 to 3 mg IV) will be given. Analgesia will also be maintained by using Ketorolac and Acetaminophen. At the end of surgery , Remaining muscular relaxation will be neutralized by administering neostigmine (0.05mg/kg)
Locations (1)
Dr Faisal Masood teaching Hospital sargodha
Sargodha, Pakistan