{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:04:24Z","timestamp":1789621464554,"version":"build-2803163510"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Background and Aims:<\/jats:title>\n Lumbar spinal anaesthesia (LSA) for endoscopic urological procedures often causes extensive sympathetic blockade, leading to hypotension, bradycardia, and delayed ambulation. Thoracic segmental spinal anaesthesia (TSSA) offers targeted sensory blockades with limited motor involvement and improved haemodynamic stability. The primary objective of the study was to compare motor block onset between TSSA and LSA. Secondary objectives included sensory block characteristics, two-segment regression time, haemodynamics, perioperative complications, and patient and surgeon satisfaction.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Forty American Society of Anesthesiologists (ASA) class I\u2013II patients were randomised to group T (TSSA,\n n<\/jats:italic>\n = 20; 1 mL 0.5% isobaric ropivacaine + 20 \u00b5g fentanyl at T11\u2013T12) or group S (LSA,\n n<\/jats:italic>\n = 20; 2 mL 0.5% hyperbaric ropivacaine + 20 \u00b5g fentanyl at L3\u2013L4). Sensory and motor block, haemodynamic parameters, rescue analgesia, satisfaction scores, and adverse events were recorded.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Group T achieved faster sensory block to T10 (1.7 \u00b1 1.08 vs 4.48 \u00b1 1.97 min,\n P<\/jats:italic>\n < 0.001), quicker maximum block height (3.42 \u00b1 1.46 vs 8.95 \u00b1 3.3 min,\n P<\/jats:italic>\n < 0.001), and shorter two-segment regression (58 \u00b1 6.5 vs 88.77 \u00b1 7.73 min,\n P<\/jats:italic>\n < 0.001). Motor block onset was similar (6.6 \u00b1 2.96 vs 5.8 \u00b1 1.67 in groups T and S, respectively), but group S had higher Bromage scores and prolonged blockade (time to Bromage score 0: 61.85 \u00b1 26.37 vs 184.21 \u00b1 30.06 min,\n P<\/jats:italic>\n < 0.001). Group S showed greater heart rate and mean arterial pressure reductions (\n P<\/jats:italic>\n < 0.05). Patients in Group T ambulated earlier than group S (152.25 \u00b1 29.76 vs 284 \u00b1 26.04 min;\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n TSSA provides less motor blockade, targeted sensory block, maintains haemodynamic stability, and enables earlier ambulation, making it a safe and effective alternative in endoscopic urological surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_226_26","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:00:14Z","timestamp":1784383214000},"page":"843-849","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparative evaluation of segmental spinal anaesthesia with conventional spinal anaesthesia in endoscopic transurethral surgery"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-8563","authenticated-orcid":false,"given":"Prashant","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5948-908X","authenticated-orcid":false,"given":"Twinkal","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1340-0228","authenticated-orcid":false,"given":"Sumedha","family":"Vashishth","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-0061","authenticated-orcid":false,"given":"Kiranpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4335-862X","authenticated-orcid":false,"given":"Devendra S.","family":"Pawar","sequence":"additional","affiliation":[{"name":"Department of Urology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1670-9822","authenticated-orcid":false,"given":"Ankur","family":"Taparia","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B. D. 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