Korean J Anesthesiol.  2001 Dec;41(6):693-698. 10.4097/kjae.2001.41.6.693.

Combination of Small Doses of Subarachnoid Bupivacaine/Fentanyl and Epidural Bupivacaine in Combined Spinal-Epidural Anesthesia for Cesarean Section

• Choi DH
• Choi HS
• Ahn HJ

• KMID: 2091635
• DOI: http://doi.org/10.4097/kjae.2001.41.6.693

Abstract

BACKGROUND: An intrathecal injection of a small-dose local anesthetic and an opioid using combined spinal-epidural anesthesia (CSEA) technique is a new trend in regional anesthesia for cesarean section. Prophylactic epidural injection may be useful to complete the new regimen.
METHODS
Spinal anesthesia via the CSEA technique was performed with 6 mg 0.5% hyperbaric bupivacaine plus 20ng fentanyl in 75 parturients undergoing cesarean section. group S (study, n = 38) received an epidural injection of 10 ml of 0.25% bupivacaine 5 min after intrathecal injection, and was compared with group C (control, n = 37) in sensory levels and Bromage scores, incidences of side effects such as hypotentsion, pain and discomfort, nausea and vomiting, dizziness, pruritus and shivering. Recovery times from sensory and motor block and the duration of postoperative analgesia were assessed between the groups.
RESULTS
Sensory block levels were higher (but remained CONCLUSIONS
Small-dose (6 mg) bupivacaine plus 20ng fentanyl was insufficient in 30% of cesarean patients. We obtained supreme analgesia without higher blocks and more side effects after a prophylactic epidural injection of 25 mg bupivacaine.

Keyword

Analgesics: fentanyl; Anesthetics, local: bupivacaine; Anesthetic technique: combined spinal-epidural; Surgery: cesarean section

MeSH Terms

Analgesia
Anesthesia*
Anesthesia, Conduction
Anesthesia, Spinal
Bupivacaine*
Cesarean Section*
Dizziness
Female
Fentanyl
Humans
Incidence
Injections, Epidural
Injections, Spinal
Nausea
Pregnancy
Pruritus
Shivering
Vomiting
Bupivacaine
Fentanyl