New technique of combined spinal-epidural anesthesia in lower limb surgery

الملخص EN

Background: There are several theories to explain the action of local anesthetic in combined spinal-epidural anesthesia (CSE), this study is to examine a technique of (CSE) that depends on the theory of leakage of epidural drugs to the subarachnoid cerebrospinal fluid (CSF).

Patients and Methods: After approval of local medical ethics committee and obtaining informed consent, 60 patients (18-80 years, ASA physical status I to IV) who listed for orthopedic lower limb surgery under CSE were included in this study.

The study design was prospective Cross-Section comparative one.

It was done in Gulan General Hospital and Gian Private Hospital in Duhok Governorate in Kurdistan Region of Iraq in the period from 01/01/2017 to 28/2/2018.

Results: the volume needed to get maximum sensory block (MSB) and the frequency of top-up doses are greater in group A than B.

The onset time of group A is longer than group B.

The mean arterial pressure was much stable in group A with less nausea and vomiting in the same group.

Addition, more patients in group A than group B were able to move against gravity.

Conclusions: the effect of this technique in combined spinal-epidural anesthesia can be compared to that of separate needle with more stable vital signs and less complications but with more allover doses of local anesthetics.