After obtaining informed consent, eligible patients will be enrolled in the study. Standard monitoring will be applied in the operating room and baseline blood pressure and heart rate will be recorded. Participants will be randomly assigned to receive either spinal anesthesia or a modified saddle block using hyperbaric bupivacaine administered in the lower back. The position of the patient after injection will differ according to the assigned anesthetic technique. The level of numbness produced by the anesthesia will be assessed, and patients with inadequate anesthesia will be excluded. Blood pressure and heart rate will be monitored regularly during surgery. Any significant decrease in blood pressure will be treated with intravenous phenylephrine. Any need to change to general anesthesia during the procedure will also be recorded.
Age 40- 90 years
Elective TURP surgery under Neuraxial Anesthesia
ASA class I and II
Contraindication to Neuraxial anesthesia
Allergic to study medications
Lack of consent
Parallel
Saddle block
DrugPatients will receive with 15 mg of hyperbaric bupivacaine at L3 L4 level using 25 G spinal needle and will be made to sit for 5 minutes before lying down
Spinal Anesthesia (bupivacaine)
DrugPatients will receive spinal anesthesia with 15mg of hyperbaric bupivacaine at L3 L4 level using 25G spinal needle and will be immediately made to lie down
Maximum fall in Mean Arterial Pressure
Maximum decrease in mean arterial pressure (MAP) from the pre-induction baseline value recorded during the intraoperative period, measured using automated oscillometric non-invasive blood pressure monitoring. MAP will be recorded at predefined intraoperative intervals, and the greatest fall from baseline will be reported in mmHg.
Conversion rate to General Anesthesia
This will be the number of patients requiring conversion of either spinal or saddle anesthesia to general anesthesia intraoperatively due to block failure
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