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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 2, March - April 2019, Pages 460-464
 

Original Article

Evaluation of Vibration Sense and Motor Power Following Epidural Anaesthesia

Neeru Luthra1, Kamakshi Garg2, Dinesh Sood3, Tej K Kaul4,Gurdas Singh5

Associate Professor, 3Professor, 4Ex-Professor and Head, 5Ex-PG, Dayanand Medical College and Hospital, Ludhiana, Punjab 141001, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.15

Abstract

Background: It is very important to see complete recovery from regional anaesthesia before ambulation and discharge of the patient. Bromage score or the Formal motor power test system are the conventional methods which have been used to see recovery from epidural block. Material and Methods: A total of fifty patients of ASA grade I and II, presenting for surgeries below the umbilicus under epidural anesthesia were taken up for the study. The block recovery was compared with the use of a 128-Hz tuning fork with the conventional tests. Conventional block recovery testing included Bromage score, Formal muscle power testing according to the British Medical Research Council, pinprick testing, and warm/cold testing. After obtaining base line values, an epidural block was performed and patients were tested every 15 minutes after surgery, till the vibration score of one less than the baseline was achieved. The results of the different methods to the time at which baseline values of vibration sense were reached were compared. Results: At the end of surgery, normal baseline power, foot flexion and foot extension strength was attained in all the 50(100%) patients at 90-100 minutes where as complete recovery of quadriceps strength was seen in 45 (90%) patients, rest of the patients with residual muscle weakness had motor power of grade IV and normal motor power Grade V was achieved in the next 10 minutes. Conclusion: Recovery of vibration sense corresponds with recovery of motor block after epidural anesthesia and may serve as an easy means of documenting recovery with a single test before discharge.


Keywords : Ambulation; Epidural Anaesthesia; Tuning Fork.
Corresponding Author : Kamakshi Garg