| Comparison of Combined Spinal Epidural Anesthesia and Spinal Anesthesia Using Small-dose Bupivacaine in Cesarean Delivery. |
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Duck Hwan Choi, Young Ok Park, Jin Gu Kang |
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Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dhchoi@smc.samsung.co.kr |
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| Abstract |
BACKGROUND
Combined spinal-epidural anesthesia (CSEA) using a small-dose spinal anesthetic has been a new method recommended for cesarean delivery since the advents of fine pencil-point spinal needles and the combined spinal-epidural technique. The aim of this study was to compare CSEA with single-shot spinal anesthesia (SA) using as small doses of hyperbaric bupivacaine as possible mixed with an opioid in both methods.
METHODS
One hundred parturients were divided into two groups: CSEA (n = 50) and SA (n = 50) groups. The CSEA Group received 6 mg of 0.5% hyperbaric bupivacaine and 20ng fentanyl followed by 10 ml of 0.25% bupivacaine 5 min later.
The SA Group was given 9 mg of 0.5% hyperbaric bupivacaine and 20ng fentanyl. We compared sensory and motor block variables, incidences of intraoperative side effects such as hypotension, nausea & vomiting and shivering, and recovery time variables in the PACU.
RESULTS
The anesthetic procedure took longer in the CSEA group. Sensory block was more rapid (P < 0.001 at 5 min after induction) and induced higher frequencies of hypotension and nausea & vomiting in the SA group. Motor block of the lower extremities was less intense and its recovery was quicker in the CSEA group.
CONCLUSIONS
In terms of the block quality, peri-operative side effects and recovery from the blocks, CSEA was better than SA for cesarean section. |
| Key Words:
Bupivacaine; Cesarean section; combined spinal epidural anesthesia; spinal anesthesia |
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