Document Detail

Combined spinal epidural causes higher level of block than equivalent single-shot spinal anesthesia in elective cesarean patients.
MedLine Citation:
PMID:  16428564     Owner:  NLM     Status:  MEDLINE    
Combined spinal epidural (CSE) is an established technique for lower segment cesarean delivery. In this study we tested the hypothesis that the spinal block from a CSE technique results in a more extensive spread of local anesthetic in the subarachnoid space than the single-shot spinal (SSS) technique. We recruited 30 ASA physical status I parturients admitted for elective lower segment cesarean delivery into our randomized, controlled, double-blind study. All patients intrathecally received 2 mL of 0.5% hyperbaric bupivacaine. The patients were randomized into one of the two groups using sealed opaque envelopes. Group S (n = 15) received a SSS technique. Group CS (n = 15) received a CSE technique using loss of resistance to 2 mL of air, but the epidural catheter was not inserted after the intrathecal drug administration. The maximal sensory block achieved in group CS was statistically higher than that in Group S (median C6 interquartile range, C5 to C8 versus median T3, T2 to T4, P < 0.001). Time taken to reach maximal sensory block was significantly longer in group CS. There were no differences in the time taken for the block to recede to T10, hemodynamic profile, or side effects. In conclusion, the CSE technique without placing an epidural catheter or administering epidural medication resulted in a significantly higher level of sensory block when compared with the SSS technique when the same dose of local anesthetic was given intrathecally.
Farida Ithnin; Yvonne Lim; Alex T Sia; Cecilia E Ocampo
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  102     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-23     Completed Date:  2006-02-21     Revised Date:  2007-03-27    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  577-80     Citation Subset:  AIM; IM    
Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore.
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MeSH Terms
Anesthesia, Epidural*
Anesthesia, Obstetrical*
Anesthesia, Spinal*
Anesthetics, Local / administration & dosage
Bupivacaine / administration & dosage
Cesarean Section*
Double-Blind Method
Injections, Spinal
Reg. No./Substance:
0/Anesthetics, Local; 2180-92-9/Bupivacaine
Comment In:
Anesth Analg. 2007 Mar;104(3):745-6; author reply 746   [PMID:  17312244 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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