| Incidence of Paresthesia during Needle-through-Needle versus Double-Segment Techniques for Combined Spinal-Epidural Anesthesia. |
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Hyun Joo Ahn, Jin Kyung Kim, Sang Bin Han, Duck Hwan Choi |
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Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dhchoi@smc.samsung.co.kr |
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| Abstract |
BACKGROUND
Paresthesia is unpleasant for patients and more importantly, is related to neurological injury in some cases. There have been few studies comparing combined spinal-epidural anesthesia (CSE) techniques such as needle-through-needle technique (NTN) and double segment technique (DST) regarding the incidence of paresthesia.
METHODS
Eighty-four parturients undergoing CSE for an elective cesarean section were divided into NTN and DST groups. A CSE was performed using 27 G Sprotte needle, 18 G Tuohy needle and 20 G multiport catheter in both groups. In the NTN group, at L3-4 or L4-5, a spinal anesthesia was performed and then an epidural catheter was inserted through the same Tuohy needle. In the DST group, an epidural catheter was inserted at L1-2 or L2-3 and then a spinal anesthesia was done two interspaces caudally. Incidences of paresthesia with each procedure were recorded with block characteristics and adverse effects.
RESULTS
Overall frequency of paresthesia was higher in the NTN group (54.8% vs. 29.3%, P = 0.033). Incidences of intrathecal paresthesia were three times higher (21.4% vs.
7.3%, not significant) and epidural paresthesia was significantly higher (45.2% vs. 22%, P = 0.044) in the NTN group. Sensory and motor block characteristics and side effects were mostly comparable between the groups.
CONCLUSIONS
Double-segment technique shows less incidence of overall paresthesia compared to needle-through-needle. |
| Key Words:
cesarean section; combined spinal epidural anesthesia; double segment technique; needle-through-needle technique; paresthesia |
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