Combined spinal-epidural-general anesthesia.

Each one of the three kinds of anesthesia (spinal, epidural, general) has its advantages and disadvantages. A new concept of combined spinal-epidural-general anesthesia (CSEGA) is illustrated with the objective of producing a new kind of anesthesia. The aim is to draw out the good from each compartment. CSEGA can be based on muscle relaxation and anesthesia on its spinal part with the epidural augmentation. The endotracheal intubation can be kept in place with a very small dose of an inhalational anesthetic. There is no need for muscle relaxant drugs, i.v. opioids or benzodiazepines, for postoperative analgesia serves the epidural catheter. Very small doses of local anesthetic drugs injected into the spinal or epidural compartments, could be all that is needed for operations on any part of the body, including thorax and head. CSEGA is a new concept in anesthesia. The mixing of regional anesthesia with general anesthesia affords the anesthesiologist the opportunity to lower the local anesthetic doses, avoid using many kinds of intravenous drugs (muscle relaxants, opioids, benzodiazepines, etc.) and to approach a kind of anesthesia that is closer to the ideal.