Comparison of thoracic vs lumbar spinal anaesthesia fo orthopaedic surgeries

Abstract

Background: Thoracic spinal anaesthesia has emerged as one of the most promising anaesthetic techniques in the recent times. On the other hand, lumbar approach has been the conventional choice  for orthopaedic surgeries since the advent of spinal anaesthesia. This study aimed at determining which approach is better suited for orthopaedic surgeries.Methods: Total 60 patients scheduled for orthopaedic surgeries were divided into two groups : group T and group L. Group T patients were given thoracic  spinal anaesthesia at the T9-T10 / T10-T11 interspace using  1.5 ml of hyperbaric bupivacaine 0.5% (5 mg/ml) + 25µg (0.5 ml) of fentanyl.  Group L patients received  2.5 ml of  hyperbaric bupivacaine 0.5% (5 mg/ml) + 25 µg (0.5 ml) of fentanyl at LI-L2/L2-L3 interspace. Authors evaluated the degree of analgesia  and  motor block,  haemodynamics  and neurological complications.Results: Onset of analgesia was faster in thoracic group - 2min. The duration of sensory  and motor block was shorter in thoracic group. There were no significant differences in haemodynamic variables and respiratory parameters between the two groups  and no neurological complication in any patient.Conclusions: Thoracic spinal anaesthesia is preferable to lumbar spinal anaesthesia for orthopaedic surgeries.