Comparative Study of Combined Spinal and Epidural and Epidural Anaesthesia in Gynaecological Surgeries

Abstract

BACKGROUND In an attempt to search for ideal regional anaesthetic technique to meet good degree of relaxation ability, to prolong the level and duration, avoiding supplementation with narcotics or general anaesthesia, minimise the total dose and side effects, we tried sequential combined spinal and epidural technique. This study was done to combine the benefits of spinal and epidural anaesthesia techniques in terms of rapidity of onset, good degree of reliable sensory and motor blockade with lowest possible doses, less side effects and less drug toxicity. MATERIALS AND METHODS Fifty patients between the ages of 20-50 years conforming to ASA Class I and II, to undergo gynaecological surgery, duration of surgery lasting around 120 minutes were included in the present study. Patients with neurological disease, anaemia, hypertension, cardiac and respiratory disorders were eliminated from the study. RESULTS Mean onset time for analgesia (3.62 minutes), time for spread of block to T4 level (9.36 minutes), better haemodynamic stability, less total drug dose, higher margin of safety, less intraoperative and postoperative side effects when compared to uncombined spinal and epidural anaesthesia. CONCLUSION Combined spinal and epidural technique is valuable and superior alternative to spinal or epidural alone.