The Effect of Prior Dural Puncture with a 27G Spinal Needle on Epidural Anesthesia for Cesarean Section.
10.4097/kjae.2000.38.1.63
- Author:
Duck Hwan CHOI
1
;
Byung Seop SHIN
;
Jie Ae KIM
Author Information
1. Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Anesthetics, local: lidocaine;
Anesthetic technique: combined spinal epidural;
epidural;
Surgery, obstetrics: cesarean section
- MeSH:
Anesthesia, Epidural*;
Cesarean Section*;
Epinephrine;
Female;
Humans;
Lidocaine;
Nausea;
Needles*;
Pregnancy;
Prospective Studies;
Punctures*;
Vomiting
- From:Korean Journal of Anesthesiology
2000;38(1):63-68
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: If started with segmental block, epidural anesthesia appears to have an inadequate sacral block in the early part of cesarean deliveries. A dural puncture using the combined spinal-epidural technique making an early sacral blockade might be a solution. METHODS: A prospective, randomized, double-blinded study was performed on forty patients who were divided into two groups (C, DP; n = 20, each). An epidural infusion of 25 ml of 2% lidocaine with epinephrine was given to the group C. A dural puncture with a 27G Whitacre needle was done before the epidural infusion in the group DP. Two-way sensory levels were checked for 15 min, just before the operation. The side effects and recovery variables were also compared between the groups. RESULTS: Initial wider cephalic block (P = 0.038, 0 min) followed by more caudal block (P = 0.023, 0.013; 5, 10 min after the completion of the epidural infusion, respectively) occurred in the DP group. After 10 min, there were no differences in both block levels. The number of dermatomes blocked was bigger in the DP group at 10 min after. Fewer patients in the DP group had nausea and/or vomiting (P = 0.044). CONCLUSIONS: Early spread of the sensory blockade, initial cephalic and then caudal, was due to the dural puncture by a 27G needle. This fast onset could make the parturients more comfortable in the early part of cesarean sections.
