ESRA19-0454 Spinal anesthesia for intestinal occlusion using bupivicaine 0.5% hyperbaric with adjuvant

Background and aims Intestinal occlusion may be mortal especially if it is accompanied by co-morbidities Spinal anesthesia could be an alternative to general anesthesia sparing cardiac and pulmonary complications. Methods A 58-year-old woman was admitted to the hospital for intestinal occlusion that occurred 2days previously. She was having abdominal pain, especially in the left side, nausea and vomiting; no gas or no defecation Her weight was 122 kg and height 160 cm. She had hypertension and diabetes mellitus type 2. She was operated 14 times for ombilical hernia and she had one c-section and orif for right shoulder Spinal anesthesia was performed in L2-L3 using bupivicaine 0.5%-3 ml and adrenaline 0.1%-0.1 ml with clonidine 0.075 mg intrathecally The block extension was T8. Hypotension was corrected with ephedrine infusion was with voluven6%-500 ml and normal saline 0.9%-2l. Results The operation went well for 4 hours. Median incision was done and an enteral anastomosis was successfully created. Hemodynamic was stable and the patient went to the wards with an EVA 40. The nasogastric tube was removed on the 4th day and she began to drink water and then liquid food and solid nutrition on the 7th day. She left home on her feet. Conclusions Spinal anesthesia for abdominal surgery with bupivicaine 0.5%hyperbaric and adjuvant such as adrenaline and clonidine give good anesthesia and analgesia for more than 4 hours.