Use of combined spinal‐epidural by obstetric anaesthetists

Blanshard, H. J.; Cook, Tim

doi:10.1111/j.1365-2044.2004.03918.x

Cited by 29 publications

(14 citation statements)

References 6 publications

(14 reference statements)

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“…KSEA'nin EA'den daha fazla uygulanmasının nedeni olarak nispeten işlem süresi uzun olsa da, spinal anesteziye benzer şekilde anestezinin hızlı başlaması ve uzamış vakalarda devamlı anestezi uygulanabilmesi açısın-dan önemli avantaj sağlamasıdır. Bununla birlikte, postoperatif analjezi yöntemi olarak güvenli ve uzun süre uygulanabilmesi klinisyenlerce KSEA'nin son yıl-larda daha fazla tercih edilmesini sağlamıştır 21 . Bu avantajları göz önünde bulundurulduğunda KSEA'nin elektif sezaryen vakalarının yeterli uygulama süresi-ne imkan vermesi nedeniyle daha fazla tercih edilmesi gerektiği düşüncesindeyiz.…”

Section: Discussionunclassified

Our management of anesthesia in elective and emergency cesarean surgery: A retrospective evaluation of the last ten years

Özmen¹,

Arslan²,

Ekinci³

et al. 2016

MMJ

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GİRİŞAnne ve bebek sağlığı için sezaryen ameliyatlarında tercih edilecek anestezi yöntemi çok önemlidir 1,2 . Bu ameliyatlarda uygulanacak anestezi yönetimi; cerrahinin aciliyeti, hastanın klinik durumu, anestezi uzmanının deneyimi ve hasta tercihine göre seçilme-lidir. Sezaryen operasyonlarında genel anestezi (GA) ve rejyonal (bölgesel) anestezi (RA) [kombine spinalepidural (KSEA), epidural anestezi (EA), spinal anestezi (SA)] yöntemleri uygulanmaktadır.GA'nin hava yolu kontrolü sağlaması, acil durumlarda hızlı indüksiyon, daha az hipotansiyon ve daha iyi ABSTRAcT

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Section: Discussionunclassified

Our management of anesthesia in elective and emergency cesarean surgery: A retrospective evaluation of the last ten years

Özmen¹,

Arslan²,

Ekinci³

et al. 2016

MMJ

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show abstract

“…Previously various studies had used this technique safely and several reports had appeared in support and since then technique had gained sufficient popularity. [1][2][3] In our study we had used 10ml of colloid (6% HES) for epidural volume extension. Safety and efficacy of colloid use in epidural space has been demonstrated in various previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Epidural volume extension (EVE) is a modification of CSEA in which fluid is injected in epidural space through epidural catheter after intrathecal spinal block. The epidural space with colloids, which compress the subarachnoid space, causes cephalic spread of intrathecal local anaesthetic to increase block height and speed of onset (Volume Effect).…”

mentioning

confidence: 99%

Effect of epidural volume extension with colloid on dose requirement for intrathecal spinal block: a double blind prospective study

et al. 2016

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INTRODUCTIONCombined spinal-epidural anesthesia (CSEA) is gaining popularity as preferred technique for caeserean sections and orthopaedic surgeries as it has rapid onset through spinal component and extension of aneasthesia and postoperative pain relief through epidural component while avoiding disadvantage of both. [1][2][3] Epidural volume extension (EVE) is a modification of CSEA in which fluid is injected in epidural space through epidural catheter after intrathecal spinal block. The epidural space with colloids, which compress the subarachnoid space, causes cephalic spread of intrathecal local anaesthetic to increase block height and speed of onset (Volume Effect). 1,4 In contrast EVE with local anaesthetic causes leaks from epidural space to subarachnoid puncture and also perineural or transdural spread of the extradural solution to enhance intensity and block duration besides volume effect. [5][6][7] In this study, we aimed to evaluate the efficacy of epidural volume extension (EVE) with colloid on dose requirement of intrathecal bupivacaine with fentanyl to ABSTRACT Background: Epidural volume extension (EVE) is a modification of combined-spinal epidural anaesthesia (CSEA) in which fluid is injected in epidural space after the intrathecal block. Fluid in epidural space compress subarachnoid space and causes cephalic spread of intrathecal drug to increase block height. Purpose of study is to determine efficacy of EVE on dose requirement of intrathecal bupivacaine when colloid was used for EVE. Methods: Sixty patients of ASA physical status I or II, scheduled for elective caesarean sections were recruited and randomized into two groups (30 each group). Group 1: CSEA in which spinal block is followed by 10 ml Colloid (HES 6%) in epidural space; Group 2: CSEA but no fluid in epidural space. Onset of sensory block and hemodynamic variables were measured at 5 min. intervals up to 40 minutes then at 10 min. intervals till end of surgery. Ineffective block was top-up by epidural 0.5% bupivacaine in incremental doses. Results: Median effective dose of intrathecal bupivacaine was significantly lower, 4.0 mg (95% CI 4.40-5.60) in group 1 versus 7.0 mg (95% CI 6.93-7.61) in group 2. Only 11 patients required ephedrine in group 1 versus 20 in group 2. Requirement of ephedrine was significantly lower 2.20 (±2.94) mg in group 1 versus 4.0 (±2.88) mg groups 2. Changes in haemodynamic variables from baseline were significantly lower in group 1 than those in group 2. Conclusions: EVE with colloid was effective in lowering dose requirement of spinal bupivacaine while patients hemodynamically were more stable.

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“…1 Many users of the technique choose conventional intrathecal doses to achieve a reliable spinal block, and then use the epidural catheter to prolong anaesthesia and administer postoperative pain relief. However, the presence of a catheter in the epidural space allows the effect of the initial intrathecal injection to be manipulated before and during surgery and various techniques have been developed to reduce spinal dose requirement with epidural injection of either saline or drugs.…”

Section: Introductionmentioning

confidence: 99%

Epidural volume extension and low-dose sequential combined spinal-epidural blockade: two ways to reduce spinal dose requirement for caesarean section

McNaught

Stocks

2007

International Journal of Obstetric Anesthesia

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Use of combined spinal‐epidural by obstetric anaesthetists

Cited by 29 publications

References 6 publications

Our management of anesthesia in elective and emergency cesarean surgery: A retrospective evaluation of the last ten years

Our management of anesthesia in elective and emergency cesarean surgery: A retrospective evaluation of the last ten years

Effect of epidural volume extension with colloid on dose requirement for intrathecal spinal block: a double blind prospective study

Epidural volume extension and low-dose sequential combined spinal-epidural blockade: two ways to reduce spinal dose requirement for caesarean section

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