Evaluation of Motor and Sensory Blockade in Continuous Spinal Anesthesia Compared to Epidural Anesthesia in Preeclamptic Patients Undergoing Cesarean Section
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- Category: Vol. 84, September 2016
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Evaluation of Motor and Sensory Blockade in Continuous Spinal Anesthesia Compared to Epidural Anesthesia in Preeclamptic Patients Undergoing Cesarean Section, AHMED ELBADAWY M. KHALIL, NESRINE A. EL-REFAI, EMAD M. ABD EL-HAFEZ, and WESAM M. ABD ALLAH
Abstract
Objectives: To evaluate the sensory and motor block of continuous spinal anesthesia compared to epidural anesthesia in mild to moderate preeclamptic patients undergoing cesarean section.
Methods: 40 mild to moderate preeclamptic patients undergoing cesarean section under regional anesthesia. Patients are randomly allocated into 2 groups, CSA group (n=20) received continuous spinal anesthesia using spinocath and were given 5mg of hyperbaric bupivacaine 0.5% + 25ug fentanyl as initial dose, and increments of 2.5mg of bupivacaine 0.5% at 5min intervals until the desired sensory level of T4. Patients of CEA group (n=20) received continuous epidural anesthesia and were given 60mg of lidocaine 2% as a test dose then the block is activated by giving 75mg of isobaric bupivacaine 0.5% + 100ug fentanyl and increments of 25mg of bupivacaine 0.5% at 15min interval until the desired level of T4. All patients were preloaded with 10ml/kg Ringer’s solution, and the block was performed at L3-L4 interspace with the patient in the sitting position through the midline approach.
Results: The performance time, onset, duration of the block were recorded in the CSA group (7.3±2.5, 6.2±2.1 and 115.4±16.3min respectively) which were significantly less performance time, faster onset and longer block duration than the CEA group (13.8±2.6, 19.6±7.2 and 100.3±14.7min, p< 0.001). The levels of sensory and motor block were assessed at 5, 10, 15, 20 and 30min after the block in both groups. There was significant difference (the p<0.001) with higher levels of sensory and motor block were observed in CSA group compared to CEA group.
Conclusion: Continuous spinal anesthesia using catheter over needle technique in anesthetic management of mild to moderate preeclamptic patients undergoing cesarean section provides less performance time, faster onset, effective sensory and motor block and longer duration than the continuous epidural anesthesia.