Modified Saddle Block vs Spinal Anesthesia for TURP

Overview

After obtaining informed consent, eligible patients will be enrolled in the study. Standard monitoring will be applied in the operating room and baseline blood pressure and heart rate will be recorded. Participants will be randomly assigned to receive either spinal anesthesia or a modified saddle block using hyperbaric bupivacaine administered in the lower back. The position of the patient after injection will differ according to the assigned anesthetic technique. The level of numbness produced by the anesthesia will be assessed, and patients with inadequate anesthesia will be excluded. Blood pressure and heart rate will be monitored regularly during surgery. Any significant decrease in blood pressure will be treated with intravenous phenylephrine. Any need to change to general anesthesia during the procedure will also be recorded.

After informed consent, patient fulfilling the inclusion criteria will be enrolled in the study. All patients will be brought into OR and standard ASA monitoring will be attached and baseline hemodynamics will be recorded. Patients will be randomly divided into two groups using computer generated random numbers. Group N patients will receive spinal anesthesia with 15mg of hyperbaric bupivacaine at L3 L4 level using 25G spinal needle while group S will receive saddle block with 15 mg of hyperbaric bupivacaine at L3 L4 level using 25 G spinal needle. Those receiving spinal anesthesia will be made to lie down immediately after intrathecal drug administration while those who received saddle block will be made to sit for five minutes and then will be made to lie down. Level of block will be assessed. Those having block less than T10 dermatome will be made excluded from the study. Intraoperatively hemodynamics will be monitored at 3 minutes interval. Any fall in blood pressure by more than 20% from baseline or fall in MAP to less than 65 mm of Hg will be noted and treated with Phenylephrine IV bolus of 50-100 Mcg. Intraoperatively any conversion to general anesthesia will also be noted.