The value of epidural volume extension in hip surgeries using combined spinal epidural anesthesia

Abstract

Background Regional anesthesia has an advantage over general anesthesia, as it is a simple, effective block, economical, and safe. Aim The aim of this study was to evaluate the value of epidural volume extension (EVE) on sensory and motor blockade in patients undergoing hip surgeries using combined spinal epidural (CSE) anesthesia. Patients and methods This study was carried out on 90 adult patients of both sexes with physical status American Society of Anestheologists I–II–III scheduled for hip surgeries and admitted at Tanta University Hospitals in the Orthopedic Department. Results In this study, 90 patients were randomly allocated into two groups (45 patients in each one): group I: received CSE only. Group II: received CSE with EVE. We found that intraoperative arterial blood pressure decreased significantly in group I than group II at 135 min (P≤0.001), intraoperative heart rate showed a significant increase in group I than group II at 135 min (P=0.022), significantly, a higher number of patients in group II reached a higher level of sensory blockade than group I, the duration of sensory and motor block showed a significant decrease in group I than group II (P<0.001), time for maximum sensory and motor block showed a significant increase in group I than group II (P<0.001), two-segment regression time and time to recover from motor block showed a significant decrease in group I than group II (P=0.028, P<0.001, respectively), and an insignificant difference between both groups as regarding to adverse effects. Conclusions CSE anesthesia with EVE is superior to CSE alone in hip surgeries as regarding to duration, level of motor and sensory block with slight affection of hemodynamic status, and indifferent as regarding to postoperative adverse effects.