To evaluate the effect of epidural volume extension with saline in combined spinal epidural for lower limb surgeries using intrathecal ropivicaine with fentanyl

We will conduct a study in 60 patients belonging ASA grade I and II aged between 45 to 65 years undergoing lower limb surgeries in Sardar Patel medical college, Bikaner(Rajasthan). This study will be aimed to identify the effectiveness of block profile provided by extending the epidural volume with normal saline for lower limb orthopaedic surgeries using a low dose intrathecal hyperbaric ropivacaine without causing hemodynamic changes. The majority of lower extremity orthopaedic surgery patients are old age and have multiple coexisting medical problems. Ensuring hemodynamic stability in these patients requires selection of appropriate techniques of regional anaesthesia, focussing on maintaining a safe and desirable level of blockade and limiting extensive sympathectomy.Combined spinal epidural anaesthesia will be given to both groups.Spinal anaesthesia will be given low dose isobaric 0.75% Ropivicaine. Group A will receive 10 ml of normal saline after 5 mins of intrathecal drug administration(EVE). Group B will not receive EVE

A. PRIMARY AIM-

• To assess and to compare the sensory blockade in terms of onset, level and regression.

• To assess and to compare the motor blockade in terms of onset level and recovery. • To compare the time at which first rescue analgesia is given epidurally.

B. SECONDARY AIM-

• To observe the haemodynamic parameters. • To observe patient and surgeon satifaction. • To observe any side effects and complications related to drugs.