Unilateral Spinal Anesthesia for High Risk Patients

Objective: Is unilateral spinal anesthesia using low volume, low dose 0.5% hyperbaric Bupivacaine helpful in avoiding cardiovascular instability in high risk patient?
Methodology: In the study we conducted at Al-Basra General Hospital (orthopedic operating
room):-93 patients were included , ASA Class III and IV, age between 40-80 years Underwent unilateral lower limb amputation ,time period : 12/01/2016 to 24/03/2020. All patients received unilateral spinal anesthesia and placed in the lateral position with operated side down and kept in this position for 10 minutes using hyperbaric 0.5% Bupivacaine (1 .1 -1.8 ml). Sensory and motor block levels were assessed, And BP (systolic & diastolic ) were monitored for 30 minutes after initiation of spinal anesthesia.
Results: Unilateral spinal anesthesia is rapidly performed and a cost-effective anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease.
Conclusion: Unilateral spinal anesthesia is effective in presrving Hemodynamic stability in
high risk patients .