Effects of spinal anaesthesia on metabolic processes.

A study conducted at P.G.I., Chandigarh to find out the effect of spinal anaesthesia on arterial blood gases, blood glucose, and pyruvate-lactate during spinal anaesthesia. All patients received night sedation of oral diazepam in dose of 0.2 mg/kg body weight. No narcotic/antisialogogue premedication was given to any patient. All patients received spinal anaesthesia with 5% lignocaine (hyperbaric), in lateral position. All patients received normal saline intravenously as a maintenance fluid. Blood samples for the measurement of blood pyruvate, lactate levels and arterial blood gas analysis were collected preoperatively, 10 minutes after the administration of spinal anaesthesia after fixation of drug, and half hour after the end of operative procedure. Even though there was continued rise in blood sugar levels intraoperatively, which persisted in postoperative period, the values were within normal clinical range. Blood lactate levels and blood pyruvate levels remained unchanged. Hypocapnoea observed intra-operatively in our report is attributed to hyperventilation. There was 12.44% fall in bicarbonate level. (P > .001) which even though statistically significant did not alter the pH. We conclude that spinal anaesthesia up to T8 level does not affect the metabolic processes.

Prophylactic metoclopramide administered immediately after the induction of anesthesia has no effect on the incidence of postoperative emesis after strabismus surgery.

OBJECTIVE: To evaluate the efficacy of metoclopramide (0.25 mg/kg) administered IV immediately after induction of general anesthesia for the prevention of postoperative emesis in children undergoing, elective strabismus surgery. DESIGN: Double blind, randomized. SETTING: Operation-theater. SUBJECTS AND INTERVENTIONS: Seventy six non premedicated children of ASA class 1 and 2 were randomly allocated to receive either normal saline or metoclopramide immediately after the induction of general anesthesia. All children received a standardized similar anesthetic technique. Postoperative analgesia consisted of oral indomethacin. RESULTS: The incidence of postoperative emesis in the metoclopramide group was 60% versus 71% in a placebo group (p < 0.05). The incidence of severe emesis (2 or > 2 vomiting) was similar in the placebo group (34.20%) and metoclopramide group (21.05%). There were no adverse reactions like excessive sedation, extrapyramidal signs and hemodynamic depression in either placebo or metoclopramide group. CONCLUSIONS: Metoclopramide in a dose of 0.25 mg/kg administered intravenously prior to manipulation of eyeball is devoid of the effects but is not effective in preventing postoperative emesis in children undergoing strabismus surgery.