Efficacy of Combined Spinal Epidural Block with Needle through Needle Single Interspace Technique and Epidural Anesthesia for Elective Infra Umbilical Orthopedic and Gynecological Surgery
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 8
Abstract
Background: Over three decades revival interest developed in effective use of regional anesthesia techniques for surgery and pain management. Objective: To evaluate the efficacy of combined spinal epidural block and epidural block. Materials and Methods: Prospective study was conducted on American Society of Anesthesiologists grade I and II patients (20 to 60 years old) posted for infraumbilical gynecological and orthopedic surgeries. Sixty patients were randomized divided into two groups of 30 each such as group A (combined spinal epidural) and group B (epidural). Various parameters were studied to evaluate efficacy of combined spinal epidural anesthesia and epidural anesthesia regarding sensory blockade (by pinprick method), motor blockade (modified Bromage scale method) and total amount of bupivacaine required. Data was analyzed using unpaired t test and chi square test with the help of MS Excel and SPSS software. Results: Onset of anesthesia (sensory blockade) in group A (combined spinal epidural) was reduced significantly (p<0.05) as compared to group B (Epidural). Extent of motor blockade, group A showed all patients had grade 3 blockade which was 100%, whereas grade 3 blockade was found in only 3 patients of group B which was 10% only. The total amount of bupivacaine required was less in group A when compared with group B. Conclusion: Combined spinal epidural anesthesia showed effective and promising future over epidural anesthesia by offering rapid onset of action, superior quality of analgesia, better muscle relaxation and less dose of local anesthetic required.
Authors and Affiliations
Guralingappa C. Upase
Keywords
Related Articles
- EP ID EP536335
- DOI 10.21088/ijaa.2349.8471.5818.11
- Views 64
- Downloads 0
Efficacy of Spinal Anaesthesia as a Safer Technique in Laparoscopic Cholecystectomy with Better Outcome
Spinal anaesthesia is always a safe, cost effective and a better option in patients where general anaesthesia can be complicated and to fulfill the purpose of postoperative analgesia. After conducting many upper abdomin...
Intrathecal Hyperbaric Bupivacaine and Isobaric Levobupivacaine for Spinal Anaesthesia: Block Characteristics and Clinical Effects
Introduction: Bupivacaine (0.5% heavy) is used to administer subarachnoid block but carries an increased risk of cardiac and central nervous system toxicity if inadvertently injected intravascularly. Levobupivacaine is S...
A Comparative Study between Continuous Epidural Infusion and Continuous Femoral Nerve Block for Post-Operative Pain Relief in Total Knee Replacement Surgeries
Background: Postoperative pain management in TKR is of imperative importance. Epidural analgesia though considered as a standard technique in postoperative pain management in TKR it was commonly associated with unwanted...
Study on Epidural Analgesia during Labour to Control Labour Pain
The severity of labour pain was recognized by the Romans, who termed delivery the poenamagna—the “great pain” or “great punishment.” Pregnancy, though is one of the most pleasant part of a woman’s life is marred by the a...
Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections
Context: Spinal anesthesia induced hypotension in parturients undergoing Cesarean section can be detrimental to both foetus and mother. Prophylactic administration of vasopressors helps in preventing hypotension thereby...