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The influence of epidural volume extension on spinal block with hyperbaric or plain bupivacaine for Caesarean delivery.
Eur J Anaesthesiol. 2008 Apr; 25(4):307-13.EJ

Abstract

BACKGROUND AND OBJECTIVE

Epidural volume extension via a combined spinal-epidural is the enhancement of a small-dose intrathecal block by an epidural injection of physiological saline solution. We evaluated the effect of epidural volume extension on the combined spinal-epidural technique of providing spinal anaesthesia for Caesarean section with hyperbaric or plain 0.5% bupivacaine.

METHODS

Patients (n = 240) with height >163 cm received 9 mg and patients <163 cm received 8 mg of bupivacaine. Each study drug was combined with 20 mug fentanyl. Using the combined spinal-epidural technique, Group A (n = 60) received hyperbaric bupivacaine, and Group B (n = 60) received hyperbaric bupivacaine and 10 mL saline epidurally 5 min after subarachnoid injection. Group C (n = 60) received plain bupivacaine and Group D (n = 60) received plain bupivacaine and 10 mL saline epidurally 5 min after subarachnoid injection. An anaesthetist blinded to the anaesthetic solution injected examined the level of analgesia by the pinprick method and motor block with the modified Bromage scale for 30 min after subarachnoid injection, during the intraoperative period and subsequently every 15 min for 135 min during the recovery period.

RESULTS

Time to reach a sensory block at T4 was significantly shorter in Groups C and D than in Groups A (P = 0.003 and 0.017) and B (P = 0.006 and 0.048), respectively. During the intraoperative period, sensory block levels were significantly higher in Group C than in Group A. Recovery was similar in all groups; only onset was faster in Groups C and D.

CONCLUSION

There was no effect of epidural volume extension on the profile of spinal anaesthesia with the combined spinal-epidural technique for Caesarean section using hyperbaric or plain bupivacaine.

Authors+Show Affiliations

Dokuz Eylül University, School of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

17888192

Citation

Kucukguclu, S, et al. "The Influence of Epidural Volume Extension On Spinal Block With Hyperbaric or Plain Bupivacaine for Caesarean Delivery." European Journal of Anaesthesiology, vol. 25, no. 4, 2008, pp. 307-13.
Kucukguclu S, Unlugenc H, Gunenc F, et al. The influence of epidural volume extension on spinal block with hyperbaric or plain bupivacaine for Caesarean delivery. Eur J Anaesthesiol. 2008;25(4):307-13.
Kucukguclu, S., Unlugenc, H., Gunenc, F., Kuvaki, B., Gokmen, N., Gunasti, S., Guclu, S., Yilmaz, F., & Isik, G. (2008). The influence of epidural volume extension on spinal block with hyperbaric or plain bupivacaine for Caesarean delivery. European Journal of Anaesthesiology, 25(4), 307-13.
Kucukguclu S, et al. The Influence of Epidural Volume Extension On Spinal Block With Hyperbaric or Plain Bupivacaine for Caesarean Delivery. Eur J Anaesthesiol. 2008;25(4):307-13. PubMed PMID: 17888192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of epidural volume extension on spinal block with hyperbaric or plain bupivacaine for Caesarean delivery. AU - Kucukguclu,S, AU - Unlugenc,H, AU - Gunenc,F, AU - Kuvaki,B, AU - Gokmen,N, AU - Gunasti,S, AU - Guclu,S, AU - Yilmaz,F, AU - Isik,G, Y1 - 2007/09/21/ PY - 2007/9/25/pubmed PY - 2008/4/5/medline PY - 2007/9/25/entrez SP - 307 EP - 13 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 25 IS - 4 N2 - BACKGROUND AND OBJECTIVE: Epidural volume extension via a combined spinal-epidural is the enhancement of a small-dose intrathecal block by an epidural injection of physiological saline solution. We evaluated the effect of epidural volume extension on the combined spinal-epidural technique of providing spinal anaesthesia for Caesarean section with hyperbaric or plain 0.5% bupivacaine. METHODS: Patients (n = 240) with height >163 cm received 9 mg and patients <163 cm received 8 mg of bupivacaine. Each study drug was combined with 20 mug fentanyl. Using the combined spinal-epidural technique, Group A (n = 60) received hyperbaric bupivacaine, and Group B (n = 60) received hyperbaric bupivacaine and 10 mL saline epidurally 5 min after subarachnoid injection. Group C (n = 60) received plain bupivacaine and Group D (n = 60) received plain bupivacaine and 10 mL saline epidurally 5 min after subarachnoid injection. An anaesthetist blinded to the anaesthetic solution injected examined the level of analgesia by the pinprick method and motor block with the modified Bromage scale for 30 min after subarachnoid injection, during the intraoperative period and subsequently every 15 min for 135 min during the recovery period. RESULTS: Time to reach a sensory block at T4 was significantly shorter in Groups C and D than in Groups A (P = 0.003 and 0.017) and B (P = 0.006 and 0.048), respectively. During the intraoperative period, sensory block levels were significantly higher in Group C than in Group A. Recovery was similar in all groups; only onset was faster in Groups C and D. CONCLUSION: There was no effect of epidural volume extension on the profile of spinal anaesthesia with the combined spinal-epidural technique for Caesarean section using hyperbaric or plain bupivacaine. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/17888192/The_influence_of_epidural_volume_extension_on_spinal_block_with_hyperbaric_or_plain_bupivacaine_for_Caesarean_delivery_ L2 - https://doi.org/10.1017/S0265021507002670 DB - PRIME DP - Unbound Medicine ER -