Volume : 5, Issue : 11, November - 2016

THE EFFECTS OF HEAD DOWN TILT PROPHYLACTICALLY IN SPINAL ANESTHESIA

Dr B Ravi, Dr Saranya Ravi

Abstract :

<p>&nbsp;WE EXAMINED THE USEFULNESS OF 5 DEGREE HEAD DOWN TILT FOR OBTAINING FASTER IDEAL SURGICAL CONDITIONS IN SPINAL ANESTHESIA USING FINER SPINAL NEDDLES (25 AND 26 SIZE) IN TWO SETS OF50 PATIENTS EACH. THE HEAD DOWN TILT BY 5 DEGREE WAS GIVEN BEFORE GIVING SPINAL IN ONE GROUP AND THE PATIENT WAS KEPT IN HORIZONTAL MODE WITHOUT TILT IN THE OTHER GROUP. NORMALLY IT TAKES 3-5 MINS TO GET IDEAL SURGICAL CONDITIONS(TO PUT THE INCISION AND PROCEED WITH THE SURGERY) WITH FINER SPINAL NEEDLES. BECAUSE THE DRUG USED IN SPINAL IS HYPERBARIC IT TENDS TO SETTLE DOWN IN THE CSF AND SLOWLY ASCENDS IN THE HORIZONTAL POSITION. IF THE 5 DEGREE HEAD DOWN TILT IS GIVEN BEFORE THE START OF THE SPINAL THE DRUG ASCENDS SLIGHTLY FASTER BECAUSE OF GRAVITY. IN THE HORIZONTAL MODE 50 CASES WERE OBSERVED AFTER SPINAL AND IT TOOK 3-5 MINS FOR ARRIVING AT IDEAL SURGICAL CONDITIONS.1 CASE HAD A SPREAD UP TO T4 LEVEL OUT OF 50 CASES. IN THE 5 DEGREE HEAD DOWN TILT BEFORE SPINAL GROUP, 50 CASES WERE OBSERVED AND IT TOOK 2-4 MINS FOR ARRIVING AT IDEAL SURGICAL CONDITIONS WITHOUT MUCH OF CEPHALOID SPREAD. ONLY 2 CASES HAD A BLOCK UP TO T4 LEVEL OUT OF 50 CASES. THE USEFULNESS OF THIS TECHNIQUE IS IN EMERGENCY SURGERIES WERE TIME IS VERY ESSENTIAL IN STARTING THE SURGERY AS SOON AS POSSIBLE WITH IDEAL SURGICAL CONDITIONS. WHEN WE USE FINER SPINAL NEEDLES IT IS REALLY DIFFICULT TO INJECT THE LOCAL ANESTHETIC DRUG FAST AND IT TAKES SOME TIME TO ASCEND AND BLOCK THE NERVES AND GET IDEAL SURGICAL CONDITIONS. WE USE FINER SPINAL NEEDLES TO AVOID POST DURAL PUNCTUE HEADACHE(PDPH)</p>