COMBINED SPINAL EPIDURAL VERSUS EPIDURAL ANAESTHESIA IN MAJOR SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 1
Abstract
BACKGROUND Combined spinal epidural anaesthesia is a comparatively recent innovation in the central neuraxial anaesthetic procedures. With proper patient and needle selection, we believe that CSEA may offer advantages over both spinal and epidural anaesthesia for outpatient surgery as well. Compared with spinal anaesthesia CSEA offers increased flexibility, because the duration of anaesthesia can be extended using the epidural catheter. Combined spinal epidural anaesthesia may also provide a decreased duration of anaesthesia by allowing administration of the minimal intrathecal dose required to establish the initial level of surgical anaesthesia. This is made possible because of the confidence afforded by the continuous techniques as a backup. Compared with epidural anaesthesia alone, CSEA has a shorter onset and virtually eliminates most of the serious complications of epidural and spinal anaesthesia. MATERIALS AND METHODS This prospective, randomised, controlled study was conducted at a tertiary care hospital incorporating 60 patients. Patients were divided into two groups using computer-generated random number table. In Group-I of 30 patients CSEA was used, while in Group-II of 30 patients EA was used. RESULTS The demographic profile of the patients in both groups was comparable with regards to age, weight and height. In Group-I the mean dose of intrathecal, extradural and total Bupivacaine was 11.07 ± 1.38 mg, 15.63 ± 3.13 mg and 28.60 ± 3.74 mg respectively. In CSEA group of 30 patients the CSE needle was inserted successfully in 93.4%, of which in about 92.8% cases of extradural catheter was placed successfully, while in EA group the epidural needle was inserted successfully in 93.3%, which in 89.3% cases the extradural catheter was placed successfully. CONCLUSION A statistically significant and progressive fall in pulse rate and blood pressure was noted in first 10 mins of combined spinal epidural anaesthesia group and in between 10 - 30 mins of epidural anaesthesia group and in between 10 - 30 mins of epidural anaesthesia group. This fall was noted because of autonomic nervous system blockade. In epidural anaesthesia group, the mean fall in blood pressure was between 20 - 30 mins and was comparatively more than in CSEA group.
Authors and Affiliations
Manoj Kumar Upadhyay, Apurva Agarwal
Keywords
Related Articles
- EP ID EP284497
- DOI 10.14260/jemds/2018/21
- Views 94
- Downloads 0
A CASE REPORT OF KRUKENBERG TUMOR’S SECONDARY TO ADENOCARCINOMA OF GALL BLADDER
Metastasis to the ovary is not rare and 5% to 10% of all ovarian malignancies are metastasis. Ovarian secondary tumors arise most commonly from primary tumors of stomach. Colon, pancreas, appendix, lung and bre...
SUTURE HAEMORRHOIDOPEXY AND ITS SHORT-TERM OUTCOME
BACKGROUND Since ancient times, haemorrhoids are known to be a common anorectal disease.[1] Many of the treatments have been widely practiced since old times. In India, this condition is associated with rural areas and l...
MEDITATION: A STRESS RELIEVER
In this study, cardiovascular parameters and respiratory functions of those practicing meditation were compared with those of non-meditators. Stress is the greatest disorder of the modern society. Health is imm...
A PROSPECTIVE STUDY TO DEFINE THE ROLE OF DIAGNOSTIC LAPAROSCOPY IN EVALUATING RIGHT LOWER QUADRANT PAIN
BACKGROUND Diagnostic laparoscopy is of tremendous help in a patient with uncertain abdominal pathology. The appropriate implementation of diagnostic laparoscopy often helps to avoid expensive diagnostic studies...
COMPARATIVE STUDY OF CAESAREAN SECTION BETWEEN CONVENTIONAL AND MISGAV-LADACH METHOD
BACKGROUND Ever since the inception of caesarean section, this particular surgery had been innovated and re-innovated to provide better results and decrease the mortality rates as well as post-operative morbidity rates....