Comparison of Combined Spinal Epidural Anesthesia and Spinal Anesthesia Using Small-dose Bupivacaine in Cesarean Delivery.
10.4097/kjae.2002.43.2.179
- Author:
Duck Hwan CHOI
1
;
Young Ok PARK
;
Jin Gu KANG
Author Information
1. Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dhchoi@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Bupivacaine;
Cesarean section;
combined spinal epidural anesthesia;
spinal anesthesia
- MeSH:
Anesthesia;
Anesthesia, Epidural*;
Anesthesia, Spinal*;
Bupivacaine*;
Cesarean Section;
Female;
Fentanyl;
Hypotension;
Incidence;
Lower Extremity;
Nausea;
Needles;
Pregnancy;
Shivering;
Vomiting
- From:Korean Journal of Anesthesiology
2002;43(2):179-185
- CountryRepublic of Korea
- Language:Korean
-
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.
