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Indian Journal of Anesthesia and Analgesia

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A Comparative Study on Safety of Combined Spinal and Epidural Anesthesia verses Epidural Anesthesia for Orthopedic and Gynecological Surgery

Guralingappa C. Upase, Senior Specialist, Department of Anesthesiology, District Hospital Vijayapur, Athani Road, Vijayapura, Karnataka 586102, India. , Guralingappa C. Upase1 , Anand N. Patil2 , Basavaraj N. Walikar3 , N.R. Bhat4 , Yashaswini K.5

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Indian Journal of Anesthesia and Analgesia 5(6):p 941-946, June 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.10

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Abstract

Background: In major surgeries, anesthesia plan requires modification as per patient’s need for safe outcome. Orthopedic and gynecological surgeries require excellent surgical conditions and prolonged and effective postoperative analgesia.

Objective: To compare the safety measures of combined spinal epidural anesthesia verses epidural anesthesia.

Materials and Methods: The randomized prospective study was conducted on 20 to 60 years old ASA grade (I and II) patients posted for orthopedic and gynecological surgeries. Sixty patients were divided into two groups of 30 each such as group A (combined spinal epidural) and group B (epidural anesthesia). Various parameters were studied to compare safety parameters of combined spinal epidural  anesthesia and epidural anesthesia in terms of quality of analgesia, hemodynamic changes and opinion feedback (patient’s opinion regarding comfort and acceptance of  technique, surgeon’s opinion regarding quality of relaxation and preference of technique). Data was analyzed using unpaired t test and chi square test with the help of MS Excel and SPSS software.

Results: The quality of analgesia was excellent in group A (CSE) as compared to group B (EA). Hemodynamic changes during anesthesia and surgery were comparable in both the groups. Surgeon’s opinion regarding motor blockade and preference of technique was in favor of group A compared to group B. Patient’s acceptance revealed equivocal in both groups.

Conclusion: Our study concludes that CSE anesthesia is more safe technique over EA for patients as well as surgeons.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.10

Keywords

Epidural Block; Combined Spinal Epidural Block; Analgesia; Hemodynamics

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