Effect of Single Epidural Saline on Spinal Sensory Blockade Level during Combined Spinal Epidural Anesthesia

Kim, Bong Il; Paek, Seung Hee; Rho, Woon Seok

Abstract

BACKGROUND: Combined spinal epidural anesthesia (CSE) is used for obtaining adventages of both spinal and epidural anesthesia. But it might be suspected that epidural volume load affect spinal sensory blockade level during CSE.
METHODS
Eighty patients undergoing lower abdominal and lower extremity operation were involved in our study. Subarachnoid block with 12mg of tetracaine was established in all patients. Four groups were studied. Group 1 (n=20), the control, received only spinal anesthesia. Group 2 (n=20), group 3 (n=20) and group 4 (n=20) received 10, 15 and 20 ml of epidural saline immediately after spinal anesthetic administration. Sensory blockade level was checked by pinprick test at 5, 10, 15, 20, 25, 30, 40, 60 and 90 minutes. Blood pressure, heart rate and incidence of complications such as hypotension, bradycardia, nausea and high block were measured.
RESULTS
The sensory blockade level of groups 3 and 4 was higher than group 1 (p<0.05). Blood pressure and heart rate were not different compared with each other. The incidence of complications, except that higher block above T4 in group 4 was more than in group 1 (p<0.05), were not different when compared with each other.
CONCLUSIONS
Epidural saline above 15 ml may affect sensory blockade level of spinal anesthesia during CSE.