Thoracic spinal anaesthesia – An effective alternative to general anaesthesia in breast surgeries: A randomised, non-blinded study

Dear Editor We would like to address the queries in response to the comments raised by one of the readers on our published article.[1,2] Blinding requires significant resources, increases the operational complexity of trials and may not always be feasible.[3] To understand and gain confidence in the safety profile of drugs, open-label studies are now increasingly used.[4] We used thoracic spinal anaesthesia for short-duration breast surgeries (≤90 min). Cancer surgeries (or axillary clearance) have not been included, hence the diathermy remark is superfluous. We monitored blood pressure every 5 min. Haemodynamic stability was maintained due to the low dose of local anaesthetic, as also stated by Abdelhamid and Elakany[5] and Khan et al.[6] Intraoperatively, the general anaesthesia group was given adequate analgesia with intravenous fentanyl and nitrous oxide. The rescue analgesic in the postoperative period was intravenous paracetamol (one or more doses, 1 g), which was planned to be given when the visual analogue scale was ≥4. The analgesia employed was not suboptimal. We did not use opioids in the postoperative period for both groups since we wanted to extrapolate the findings to daycare surgery and observe whether the patients were ready for discharge after 24 h for future research. Further studies are required in this direction. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.