Abstract
Introduction: The technique of combined spinal epidural (CSE) anaesthesia has become popular for patients undergoing elective infraumbilical surgeries where intraoperative prolonged and effective post-operative analgesia is required. CSE has the reliability of subarachnoid block as well as the flexibility of epidural block. The epidural volume expansion (EVE) technique is a modification of CSE in which the level of sensory analgesia obtained by subarachnoid block is increased by saline administered through the epidural catheter. Aims and Objectives: The present study was designed to compare different volumes of normal saline (10ml and 15ml) for epidural volume expansion on spinal anaesthesia with 10 mg (2 ml) of 0.5% hyperbaric bupivacaine for elective infraumbilical surgeries in adult patients with respect to sensory and motor block characteristics and haemodynamic stability. Materials and Methods: In this randomized, double blind, prospective study, ninety patients of ASA I and II of age group 18 – 59 years undergoing elective infraumbilical surgeries were randomly assigned into three groups namely group 0, group 10 and group 15. Combined Spinal Epidural technique was performed using double segment technique in lateral position in all the patients. Group 0 received 10 mg of 0.5% hyperbaric Bupivacaine intrathecally without EVE, group 10 received 10mg of 0.5% hyperbaric Bupivacaine followed by EVE with 10 ml of normal saline, group 15 received 10mg of 0.5% hyperbaric Bupivacaine followed by EVE with 15 ml of normal saline. Results: There were no statistically significant difference in the demographic data among the studied groups. Regarding block profile, the time of onset of sensory block was found to be statistically insignificant whereas a significant difference was noted among the three groups regarding maximum level of sensory blockade. Time to achieve maximum level of sensory blockade was observed to be longest in group 15 (mean ± SD: 4.76 ±0.72 minute
Highlights
The technique of combined spinal epidural (CSE) anaesthesia has become popular for patients undergoing elective infraumbilical surgeries where intraoperative prolonged and effective post-operative analgesia is required
One of the modifications of CSE technique is the Epidural volume expansion (EVE), wherein the level of sensory analgesia after subarachnoid block is increased by administering normal saline or local anaesthetic through the epidural catheter.[3]
Various volumes of normal saline (5ml, 10ml, 15ml and 20mL) have been used for EVE technique but there is no consensus regarding the effective volume of normal saline for epidural volume expansion on the sensory and motor block characteristics of spinal anaesthesia
Summary
The technique of combined spinal epidural (CSE) anaesthesia has become popular for patients undergoing elective infraumbilical surgeries where intraoperative prolonged and effective post-operative analgesia is required. Aims and Objectives: The present study was designed to compare different volumes of normal saline (10ml and 15ml) for epidural volume expansion on spinal anaesthesia with 10 mg (2 ml) of 0.5% hyperbaric bupivacaine for elective infraumbilical surgeries in adult patients with respect to sensory and motor block characteristics and haemodynamic stability. Anaesthesia has become popular for patients undergoing infraumbilical surgeries who require prolonged and effective intra operative and post operative analgesia.[1] CSE technique reduces or eliminates some of the disadvantages of spinal anaesthesia while preserving their advantages.[2] One of the modifications of CSE technique is the Epidural volume expansion (EVE), wherein the level of sensory analgesia after subarachnoid block is increased by administering normal saline or local anaesthetic through the epidural catheter.[3]. Various volumes of normal saline (5ml, 10ml, 15ml and 20mL) have been used for EVE technique but there is no consensus regarding the effective volume of normal saline for epidural volume expansion on the sensory and motor block characteristics of spinal anaesthesia
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