ABSTRACT : The aim of this study was to evaluate the safety and efficacy of low dose continuous segmental epidural in patients with echocardiography finding of regional wall motion abnormality posted for below umbilical elective surgeries and to assess its efficacy of providing surgical anaesthesia, Intraoperative complications and postoperative benefits and complications.

METHODS : : In the present study 30 patients who are scheduled for elective below umbilical surgeries with regional wall motion abnormality with ejection fraction of 50 and below are enrolled in this study. Lorazepam 2mg orally and Midazolam 1 mg administered as premedication. In sitting position under aseptic precautionL3- L4 epidural space identified and 4 ml of 2% Xylocaine given in epidural space. Epidural catheter passed and secured.

Butorphanol 2 mg given intravenously. With a gap of 4 minutes 4 ml of 2% Xylocaine given 2 times. After 45 minutes of first dose of Xylocaine 6 ml of 0.25 % Ropivacaine administered and continued at rate of 6 ml per hour for 48 hours

RESULTS : Male Female ratio is 18:12 and means age of the patients is 66.72±9.52, mean ejection fraction is 42.66±6.70. Mean duration of onset of epidural is 9.51±1.21, mean duration of surgery is 50.26±14.57. Hemodynamics maintained well intra operatively. Buprenorphine 200µg administered epidurally, Stay of the patient in I.C.U.is 48 hours.

CONCLUSIONS : low dose continuous segmental epidural anaesthesia is safer anaesthesia technique in patients with regional wall abnormality scheduled for below umbilical surgeries.