Comparison of Combined Spinal Epidural Anesthesia and Spinal Anesthesia Using Small-dose Bupivacaine in Cesarean Delivery

Abstract

Background: Combined spinal-epidural anesthesia (CSEA) using a small-dose spinal anesthetic has been a new method recommended for cesarean delivery since the advents of fine pencil-point spinal needles and the combined spinal-epidural technique. The aim of this study was to compare CSEA with single-shot spinal anesthesia (SA) using as small doses of hyperbaric bupivacaine as possible mixed with an opioid in both methods. Methods: One hundred parturients were divided into two groups: CSEA (n = 50) and SA (n = 50) groups. The CSEA Group received 6 mg of 0.5% hyperbaric bupivacaine and 20g fentanyl followed by 10 ml of 0.25% bupivacaine 5 min later. The SA Group was given 9 mg of 0.5% hyperbaric bupivacaine and 20 fentanyl. We compared sensory and motor block variables, incidences of intraoperative side effects such as hypotension, nausea & vomiting and shivering, and recovery time variables in the PACU. Results: The anesthetic procedure took longer in the CSEA group. Sensory block was more rapid (P