Combined Spinal-Epidural Anesthesia with Epidural Volume Extension causes a Higher Level of Block than Single-Shot Spinal Anesthesia


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Salman C., KAYACAN N., Ertusgrul F., BİGAT Z., KARSLI B.

REVISTA BRASILEIRA DE ANESTESIOLOGIA, cilt.63, sa.3, ss.267-272, 2013 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 63 Sayı: 3
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1590/s0034-70942013000300007
  • Dergi Adı: REVISTA BRASILEIRA DE ANESTESIOLOGIA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.267-272
  • Anahtar Kelimeler: Anesthesia, Spinal, Epidural, Injections, Epidural, Anesthetics, Local, Bupivacaine/levobupivacaine, Cesarean Section, ELECTIVE CESAREAN DELIVERY, TOP-UP, INTRATHECAL LEVOBUPIVACAINE, HYPERBARIC BUPIVACAINE, DOSE REQUIREMENT, SECTION, ROPIVACAINE, INJECTION, MECHANISM, OPIOIDS
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background and objectives: We evaluated the effects of epidural injection with levobupivacaine or serum physiologic, epidural volume extension (EVE), when using combined spinal-epidural anesthesia (CSEA) for cesarean delivery.

Abstract

Background and objectives: We evaluated the effects of epidural injection with levobupivacaine or serum physiologic, epidural volume extension (EVE), when using combined spinal-epidural anesthesia (CSEA) for cesarean delivery. 

Methods: One-hundred and thirty-eight patients with a full-term pregnancy of 37-42 weeks that were scheduled for cesarean delivery were included. Group 1 (n = 48) received single-shot spinal anesthesia (SSS), group 2 (n = 45) received CSEA-EVE with saline, group 3 received CSEA-EVE with levobupivacaine. The characteristics of motor and sensory block, the effects on maternal hemodynamic changes and the effects on the newborn were compared. 

Results: Time to reach maximum sensory block was significantly shorter in groups 3 than in group 1 and 2 (p < 0.05). Two-segment regression time of sensory block was significantly shorter in group 1, whereas it was significantly longer in group 3 than in group 2 (p < 0.05). Time to onset of motor block was significantly longer in group 1 than in groups 2 and 3 (p < 0.05). Time to reach maximum motor block was significantly shorter in group 3 than in groups 1 and 2 (p < 0.05). Time to recovery of motor block was significantly longer in group 3 than in groups 1 and 2 (p < 0.05). The time to first analgesic was significantly longer in group 3 (p < 0.05). 

Conclusions: Sufficient and rapid motor and sensory block was achieved in all the patients in the present study; however, motor and sensory block had faster onset, lasted longer, and was of a higher level in groups 2 and 3; these effects were more pronounced in the group 3. (C) 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.