[Comparison of continuous spinal and combined spinal-epidural anesthesia in patients for uterectomy].

OBJECTIVE

To compare the anaesthetic effect and hemodynamic changes between the continuous spinal anaesthesia(CSA) and combined spinal-epidural anaesthesia (CSEA) in patients for uterectomy.

METHODS

Sixty patients undergoing uterectomy were randomly divided into two groups: CSA group and CSEA group. Spinal anesthesia was performed at L2-3 interspace. An initial subarachnoid bolus of 0.5% hyperbaric bupivacaine 2 ml was injected in the CSA group; if analgesia did not reach T8, supplemental bupivacaine was injected by titrate incremental doses. In the CSEA group, epidural anesthesia was performed at T12-L1 with a catheter inserted into the epidural space for anesthesia maintenance, and then 0.5% hyperbaric bupivacaine 3 ml was injected to the subarachnoid at L2-3. The levels and times of sensory and motor block and hemodynamic changes were measured and analysed.

RESULTS

The anesthetic dosage of the CSA group was smaller than that of the CSEA group (group P < 0.05). The times of sensory block to T8 or the maximal level and motor block were more rapid in the CSEA group than those of the CSA group (P < 0.05). Mean arterial pressure (MAP), which decreased significantly, was related with the baseline in the two groups; the time was 15 min and 25 min in the CSEA group and CSA group respectively (P < 0.05). There was no difference in the maximum decline of MAP in the two groups (P < 0.01).

CONCLUSION

CSA is a safe technique of spinal anesthesia with small anesthetic dosages, more reliable and hemodynamically stable in patients for uterectomy.