Comparison of Taylor Approach vs Lumbar Approach of Spinal Anaesthesia in Terms of Difficulty to Perform in Patients Undergoing Transuretheral Resection of Prostate

Abstract

Taylor modified paramedian approach (Taylors approach) which is reliable and less traumatic alternative in difficult spine . The purpose of the present study was to compare taylor approach vs lumbar approach of spinal anaesthesia in terms of difficulty to perform in patients undergoing transuretheral resection of prostate. 30 patients (Group C) received SPA by a L4/5 approach and 30 patients by Taylor’s approach (Group T). Bupivacaine dose did not differ between groups. we observed total number of attempts in each group. The mean number of attempts per successful block in Group C and Group T was 1.13 ± 0.3 and 1.5 ± 0.6 respectively. The p value was 0.003 which was found to be statistically significant. (p value less than 0.005). So, taylors approach of spinal anesthesia is difficult to perform as compared to conventional approach and require expertise. Introduction Subarachnoid anesthesia provides excellent surgical operating conditions for transuretheral resection of prostate 1 . TURP can be performed under spinal anaesthesia or general anaesthesia, however the choice of anaesthetic technique for TURP is spinal anaesthesia as it offers many advantages over general anaesthesia including stable haemodynamic variables, decrease blood loss and post operative pain, less chances of deep venous thrombosis after surgery , decrease postoperative confusion and faster recovery 2,3 . Subarachnoid anesthetic techniques have proved to be extremely safe and require a small volume of drug, virtually devoid of systemic pharmacologic effects, to produce profound, reproducible sensory analgesia, and motor blockade 4 . Midline approach of spinal anaesthesia is the most commonly used technique but it has got limitations in patients who cannot flex adequately because of pain and ossified ligaments in old age. In these patients paramedian approach is very useful 5 . In 1940 Taylor described modified paramedian approach (Taylor or lumbosacral approach) via L5-S1 space which is reliable, less traumatic in difficult spine and causes less hemodynamic side effect 6 . Kumkum Gupta et al 4 in 2011 studied subarachnoid block with Taylors approach for http://jmscr.igmpublication.org/home/ ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v9i6.17