PMID: 9552785Apr 29, 1998Paper

Sensory block extension during combined spinal and epidural

Regional Anesthesia and Pain Medicine
C MardirosoffJ Massaut

Abstract

During a combined spinal and epidural technique, extension of sensory block by epidural injection of saline or bupivacaine has been demonstrated and attributed to a volume effect or to the combination of a volume effect with a local anesthetic effect. This two-part study was designed to evaluate the time dependency of the volume effect and the local anesthetic effect on the mechanism of spinal block extension. We performed two prospective studies. Thirty patients were randomized in each study. A combined spinal and epidural was performed in a sitting position in all groups. The patients in the first study received 15 mg hyperbaric bupivacaine intrathecally and were placed supine 2 minutes after spinal injection. They received 10 mL epidural saline either 5 minutes after spinal (group A) or 20 minutes after spinal (group B) compared to a control group (group C). The patients in the second study received 12.5 mg hyperbaric bupivacaine intrathecally and were placed supine 5 minutes after spinal injection. They then received epidurally either 10 mL saline 7 minutes after spinal (group D) or 10 mL bupivacaine 7 minutes after spinal (group E) or nothing (group F). Sensory block levels were assessed by a loss of sensation to cold usin...Continue Reading

Citations

Aug 10, 2000·Anesthesiology Clinics of North America·N RawalA Van Zundert
Apr 23, 2008·European Journal of Anaesthesiology·A Tyagi
Mar 1, 2000·Acta Anaesthesiologica Scandinavica·D H ChoiI S Chung
May 8, 2014·Journal of Anaesthesiology, Clinical Pharmacology·Asha TyagiAshok Kumar Sethi
Aug 24, 2004·International Journal of Obstetric Anesthesia·Y LimE Goh
Sep 13, 2005·International Journal of Obstetric Anesthesia·Y LimC Ocampo
Apr 19, 2016·Anesthesia and Analgesia·Valerie ZaphiratosDolores M McKeen
Dec 14, 1999·Anaesthesia·T M Cook
Aug 5, 2000·Anaesthesia·L A Gomez-Bordas, F Plaat

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