Clinical Outcomes of Spinal Anesthesia Performed with or Without Barbotage: A Comparative Study

Abstract

Background: Spinal anesthesia is commonly used for lower limb and lower abdominal surgeries. Barbotage, the technique of aspirating and reinjecting cerebrospinal fluid during anesthetic delivery, may influence the spread and effectiveness of anesthesia. Although previous studies show mixed results regarding its benefits, clinical data on onset time, block level, duration, and patient satisfaction remain limited. This study compares outcomes of spinal anesthesia with and without barbotage in elective surgical patients. Objectives: To compare sensory and motor block onset, block level, duration, and hemodynamic outcomes in spinal anesthesia with or without barbotage. Methods and Materials: This comparative cross-sectional study was conducted at Ad-din Sakina Medical College Hospital (ASMCH), Pulerhat, Jashore and Kings Hospital Pvt. Ltd., Jashore, from June 2023 to May 2024. Fifty-six patients were equally divided into barbotage and non-barbotage groups. Data were collected using standardized forms after consent. Statistical analysis was done using SPSS v26. Ethical clearance was obtained, and all procedures followed the Declaration of Helsinki for human research ethics. Result: Among 56 patients, barbotage significantly improved outcomes: 71.4% had sensory block onset within 3 minutes vs. 42.9% without barbotage 78.6% had motor block onset ≤5 minutes vs. 57.1%. Higher sensory levels (T4–T6) were more frequent (60.7% vs. 35.7%), and longer block duration (2–3 hours) occurred more with barbotage (64.3%). Hypotension was lower (21.4% vs. 39.3%), and satisfaction scores were higher in the barbotage group (53.6% vs. 32.1%). Conclusion: Barbotage enhances spinal anesthesia by improving block onset, duration, sensory level, hemodynamic stability, and patient satisfaction compared to non-barbotage.