Wipe Out Period of Spinal Anaesthesia in Patients of Hemorrhoidectomy in relation to Prakriti

Abstract

Background: Surgical hemorrhoidectomy is most effective treatment for hemorrhoids. This procedure is commonly undertaken under spinal anaesthesia which produces intense sensory and motor blockade. In Clinical Practice of Anaesthesia, it is always seen that patients behave in a different manner even after the fact that they all are induced with similar anaesthetic agents with similar techniques of anaesthesia and maintained by similar anaesthetic agents. The difference in their behaviour is related to their physical, physiological and psychological status & to evaluate this difference, present research work was done. The patients were posted for hemorrhoidectomy under LSAB injection Bupivacaine 0.5% as 12.5 mg (2.5ml) dose. Wipe out period checked after waning the effect of anaesthesia and onset of pain. Objectives: To evaluate the wipe out period of spinal anesthesia and studying its relation to different Doshaja Prakriti means how metabolism of the drug Bupivacaine is affected by specific Doshaja Prakriti of the human body. Materials and Methods: Clinical study has been accomplished by dividing patients in three groups i.e., Group I, Group II and Group III. Sample size - Total 60 patients. Intervention - Group I - Vata Pradhan, Group II - Pitta Pradhan, Group III - Kapha Pradhan. Results: Wipe out period of spinal anaesthesia is ~3-4 hrs in 85% patients belonged to Group I and ~4-5 hrs in 90% patients belonged to Group II while ~5-6 hrs in 70% patients belonged to Group III. Thus, it is concluded that wipe out period of spinal anesthesia of Vataj Prakriti is less than Pittaj and Kaphaj Prakriti. The intergroup difference was statistically highly significant at p<0.001. Conclusion: The descriptions in Ayurveda indicates that individuals with Vata & Pitta Prakriti are fast metabolizers while those of Kaphaj Prakriti are slow metabolizers, which may be comprehended to the extent.