Background:
@EN spinal anesthesia is a simple technique requiring a small dose of local anesthetic to provide intense and reliable block. And epidural anesthesia with the catheter technique gives a better control of the level of analgesia and a good
postoperative
pain relief using opioids, local anesthetics or both. Therefore, the combined spinal epidural (CSE) anesthesia was evaluated to provide rapid onset of action, good muscle relaxation, prolonged duration of the block and postoperative pain relief.
@ES Methods:
@EN All patients were placed in lateral position. Using a midline approach at L3-4 interspace, a 18G Tuohy needle was introduced into the epidural space. A 27G Whitacre spinal needle was passed through the Tuohy needle until free flow
cerebrospinal
fluid, and than 0.5% heavy bupivacaine 3ml(15mg) was injected. The spinal needle was withdrawn and the epidural catheter was inserted. The dermatome level and time of sensory block was evaluated using loss of sensation of pinprick test every 1
minute
for 30 minutes, until the maximum sensory block was established. Notor block was assessed using the Bromage scale. And postoperatively we interviewed the patients for opinions on the blockade and complication.
@ES Results;
@EN The mean values of maximum sensory block level were T8(T8.0±1.7 dermatome) and at that time was 8min 30sec(8.5±1.2min). The motor blockade of lower extremity was Bromage 3 in all patients. Prolonged anesthesia over 2 hours of operation was
accomplished by adding 0.5% bupivacaine through epidural catheter. Subjective evaluation by the patients about postoperative pain control was excellent.
@ES Conclusions;
@EN CSE anesthesia appears to combine the reliability and rapid onset of spinal block, and the ability to extend the block and postoperative analgesia by using the epidural catheter while minimizing their rawbacks. (Korean J Anesthesiol 1996; 30:
461~465)
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