Combined spinal-epidural vs. epidural anesthesia in abdominal surgery
- Author:
Martires Clifton J.
;
Nuevo Florian
- Publication Type:Journal Article
- MeSH:
Human;
Aged;
Middle Aged;
Adult;
Young Adult;
Adolescent;
ANESTHESIA;
ANESTHESIA, EPIDURAL;
ANESTHESIA, SPINAL;
OBSTETRICS, ORTHOPEDICS
- From:
Philippine Journal of Surgical Specialties
1999;11(2):6-13
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND: Combined spinal-epidural anesthesia is becoming popular especially in obstetrics and orthopedics, however few studies have been done involving abdominal operations
METHODOLOGY: A randomized, blind study was conducted to compare the clinical outcome of combined spinal-epidural anesthesia (CSEA) with epidural anesthesia (EA) in abdominal surgery. CSEA was established using tetracaine 0.5 percent for the spinal component and bupivacaine 0.5 percent for the epidural component, whereas EA was established using bupivacaine 0.5 percent and fentanyl. Sixty patients were enrolled (Group CSEA, n=30; Group EA, n=30)
RESULTS: The ease of doing the procedures were similar in both groups. Of the two techniques, CSEA was associated with earlier onset times (p0.05), more intense motor block (100 percent in the CSEA group achieved compete motor block compared to 10 percent in the EA group). Ephedrine use was similar in both groups. Pain scores were similar in both groups. Overall patient satisfactions were higher in the CSEA groups. The incidence of shivering was higher in the EA group (33 percent) compared to CSEA group (17 percent). Pruritus was present only in the EA group (10 percent). Nauses, vomiting, and headache were absent in both groups
CONCLUSIONS: CSEA is a useful and safe technique that confers advantages over the EA technique for major abdominal surgery. CSEA has low failure rates, rapidly produces a reliable spinal blockade, provides good operating conditions, and offers high level of patient satisfaction.
