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Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery.
Int J Obstet Anesth 2006; 15(1):13-7IJ

Abstract

Combined spinal-epidural anesthesia balancing low-dose intrathecal bupivacaine/fentanyl and low-dose epidural bupivacaine may be more useful than single-shot spinal anesthesia for cesarean delivery in reducing incidences of adverse effects such as hypotension and nausea and in shortening motor recovery. Combined spinal-epidural anesthesia (n=50) or spinal anesthesia (n=50) was randomly performed in 100 parturients. Intrathecal bupivacaine 6 mg added by fentanyl 20 mug followed after 5 min by 10 mL of 0.25% epidural bupivacaine were used for combined spinal-epidural and intrathecal bupivacaine 9 mg with fentanyl 20 mug for spinal anesthesia. The initial sensory block level was higher in the spinal group (P<0.001), although the maximum levels were the same (T3). Complete surgical anesthesia was achieved and no patient complained of intraoperative pain in either group. Patients in the spinal group had denser motor block in the extremities and a higher incidence of hypotension (P<0.05) and nausea and vomiting (P<0.05). Motor recovery was faster in the combined spinal-epidural group (P<0.001). We concluded that combined spinal-epidural anesthesia using low-dose local anesthetic-opioid spinal anesthesia and routine epidural supplementation before surgery had some potential advantages over single-shot spinal anesthesia in the lower incidences of adverse effects and quicker recovery.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dhchoi@smc.samsung.co.krNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16256330

Citation

Choi, D-H, et al. "Combined Low-dose Spinal-epidural Anesthesia Versus Single-shot Spinal Anesthesia for Elective Cesarean Delivery." International Journal of Obstetric Anesthesia, vol. 15, no. 1, 2006, pp. 13-7.
Choi DH, Ahn HJ, Kim JA. Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery. Int J Obstet Anesth. 2006;15(1):13-7.
Choi, D. H., Ahn, H. J., & Kim, J. A. (2006). Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery. International Journal of Obstetric Anesthesia, 15(1), pp. 13-7.
Choi DH, Ahn HJ, Kim JA. Combined Low-dose Spinal-epidural Anesthesia Versus Single-shot Spinal Anesthesia for Elective Cesarean Delivery. Int J Obstet Anesth. 2006;15(1):13-7. PubMed PMID: 16256330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery. AU - Choi,D-H, AU - Ahn,H-J, AU - Kim,J-A, Y1 - 2005/10/26/ PY - 2005/02/01/received PY - 2005/05/01/revised PY - 2005/05/01/accepted PY - 2005/11/1/pubmed PY - 2006/5/11/medline PY - 2005/11/1/entrez SP - 13 EP - 7 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 15 IS - 1 N2 - Combined spinal-epidural anesthesia balancing low-dose intrathecal bupivacaine/fentanyl and low-dose epidural bupivacaine may be more useful than single-shot spinal anesthesia for cesarean delivery in reducing incidences of adverse effects such as hypotension and nausea and in shortening motor recovery. Combined spinal-epidural anesthesia (n=50) or spinal anesthesia (n=50) was randomly performed in 100 parturients. Intrathecal bupivacaine 6 mg added by fentanyl 20 mug followed after 5 min by 10 mL of 0.25% epidural bupivacaine were used for combined spinal-epidural and intrathecal bupivacaine 9 mg with fentanyl 20 mug for spinal anesthesia. The initial sensory block level was higher in the spinal group (P<0.001), although the maximum levels were the same (T3). Complete surgical anesthesia was achieved and no patient complained of intraoperative pain in either group. Patients in the spinal group had denser motor block in the extremities and a higher incidence of hypotension (P<0.05) and nausea and vomiting (P<0.05). Motor recovery was faster in the combined spinal-epidural group (P<0.001). We concluded that combined spinal-epidural anesthesia using low-dose local anesthetic-opioid spinal anesthesia and routine epidural supplementation before surgery had some potential advantages over single-shot spinal anesthesia in the lower incidences of adverse effects and quicker recovery. SN - 0959-289X UR - https://www.unboundmedicine.com/medline/citation/16256330/Combined_low_dose_spinal_epidural_anesthesia_versus_single_shot_spinal_anesthesia_for_elective_cesarean_delivery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(05)00105-6 DB - PRIME DP - Unbound Medicine ER -