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Korean J Anesthesiol > Volume 49(2); 2005 > Article
Korean Journal of Anesthesiology 2005;49(2):188-192.
DOI: https://doi.org/10.4097/kjae.2005.49.2.188   
Combined Spinal-Epidural Anesthesia Using Epidural Volume Extension for Elective Cesarean Delivery.
Ae Ra Kim, Kyu Hyun Oh
Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University, Daegu, Korea. aera420@dsmc.or.kr
Epidural volume extension (EVE) via a combined spinal-epidural (CSE) technique involved the enhancement of a small-dose intrathecal block using epidural saline boluses. We compared the EVE technique and single-shot spinal anesthesia with respect to sensory and motor block profiles and hemodynamic stabilities.
Seventy parturients undergoing elective cesarean deliveries were administered either spinal anesthesia with hyperbaric 0.5% bupivacine 10 mg plus fentanyl 15microgram or CSE anesthesia (comprising intrathecal hyperbaric 0.5% bupivacine 7 mg with fentanyl 15microgram followed by 0.9% saline (5.0 ml)) through a Tuohy needle. In each group, the lowest systolic blood pressure, sensory block level and peak sensory block height to loss of cold sensation to ice were recorded at 1 min intervals. Modified Bromage motor scores and time for sensory regression to the tenth thoracic dermatome (T10) were compared between groups in the PACU.
Patients in the CSEA group demonstrated significantly faster motor recovery to modified Bromage 0 (82.2 +/-18.7 min versus 121.1 +/- 15.2 min respectively, P <0.05).
Our study shows that CSE with EVE provides adequate anesthesia for elective cesarean delivery at only 70% of the bupivacine dose and allows a more rapid motor recovery of the lower limbs, which may have a beneficial impact on PACU stay.
Key Words: bupivacaine; cesarean delivery; spinal anesthesia; combined spinal-epidural anesthesia


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