Effective of using low doses bupivacaine in spinal anaesthesia for transuretheral resection of prostate surgery

This study was carried out in the department of anaesthesia and reanimation at Alassad ,Tishreen university hospitals ,Lattakia ,Syria ,during the year 2015 -2016 ,and included 80 patients undring transurethral resection of the prostate (TURP). Patients were divided into two groups : Patients of group A: recieved spinal anaesthesia by using combination between bupivacain 10mg and fentanyl ( 50mcg). Patients of group B :recieved spinal anaesthesia by using standard doses . The goal of the study : transurethral resection of the prostate (TURP ) can be perfomed under spinal anesthesia with alow dose of bupivacaine , which can be used as an alternative to the standard dose . Conclusion : using low doses Bupivacaine and fentanyl provides an aduqute anaesthesia with stable hymodynamics and less complication for patients undering transurethral resection of the prostate ( TURP ).

pars-plana-vitrectomy under retrobulbar anesthesia using a combination of Bupivacaine 0.5% and lidocaine 2%

Aim: Study of advantages of retrobulbar anesthesia and its complications in posterior vitrectomy using 0.5% bupivacaine with lidocaine 2% Materials and Methods: Number of study patients: 1000 patients who underwent a retrobulbar anesthesia using a combination of 4 ml bupivacaine 0.5% + 6 ml lidocaine 2% for a Pars-planaposterior vitrectomy. Results: Patients aged between 16-85 years, 55% of whom were males and 45% females, the indications of the Pars-plana vitrectomy were: 45% diabetic retinopathy, 15% macular hole, 10 lens-luxation , 7% artificial lens dislocation, 5% chorioiditis,5% posttraumatic vitreous haemorrhage , 5% macular pucker, 5% rhegmtogenous retinal detachment, 5% intraocular foreign body, 0.5% endophthalmitis. Complications: 0.4% retrobulbar hemorrhage, 2% elevated intraocular pressure, 0.2%, expulsive choreoidale haemorrhage, pain 8%, fear, anxietyand tension 0.2%, eyelid haematome 4%, patient movement 1.3% , diplopia 1%, ptosis 1,3%, low heart rate and low arterial pressure 0.3%. Conclusion : retrobulbar anesthesia is recommended with the combination of bupivacain and lidocaine in the posterior vitreorectomy, with some exceptions such as drug allergies, single eye, high myopy, advanced optic nerve lesions, children, no coopertion.