scholarly journals A Randomized Double-Blind Comparison of the Double-Space Technique versus the Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section

2020 ◽  
Author(s):  
Eun Hee Chun ◽  
Sooyoung Cho ◽  
Jae Hee Woo ◽  
Youn Jin Kim
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Sensory Block ◽  
Single Group ◽  
Double Blind ◽  
Space Technique ◽  
Double Space ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural ◽  
Double Group

Abstract Background: Combined spinal-epidural anesthesia (CSEA) can be performed with either a single-space technique or a double-space technique for cesarean section. We performed a double-blind randomized controlled study to compare the effect of the double-space technique with that of the single-space technique on sensory block level and side effects. Methods: Parturients undergoing elective cesarean section under regional anesthesia were randomized to receive CSEA with either the double-space technique (double group, n = 20) or the single-space technique (single group, n = 20). In the double group, an epidural catheter was inserted at the L1–2 interspace, and dural puncture was performed at the L3–4 interspace. In the single group, the procedure was performed at the L3–4 interspace using the needle-through-needle technique. Results: There were no differences in time to readiness or intraoperative level of sensory block between the two groups. The postoperative sensory level was maintained at a higher level in the double group than in the single group (1 h postoperatively, P = 0.029; 6 h postoperatively, P = 0.016). There was no difference between the two groups in terms of side effects. The parturient satisfaction scores 48 h postoperatively were significantly different between groups (9.5 in the double group vs. 8 in the single group, P = 0.004). Conclusions: We conclude that there were no differences in intraoperative variables between the double-space technique and the single-space technique for CSEA. However, double-space CSEA for cesarean section may be beneficial for controlling postoperative pain and improving parturient satisfaction. Trial registration: The study was retrospectively registered at https://cris.nih.go.kr under the trial ID KCT0002514. Date of registration: October 27, 2017.

scholarly journals A Randomized Double-Blind Comparison of Double-Space Technique versus Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section

2019 ◽  
Author(s):  
Eun Hee Chun ◽  
Sooyoung Cho ◽  
Jae Hee Woo ◽  
Youn Jin Kim
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Sensory Block ◽  
Single Group ◽  
Double Blind ◽  
Space Technique ◽  
Double Space ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural ◽  
Double Group

Abstract Background: Combined spinal-epidural anesthesia (CSEA) can be performed as either a single-space technique or a double-space technique for Cesarean section. We performed a double-blind randomized controlled study to compare the effect of the double-space technique with that of the single-space technique on the sensory block level and side effects. Methods: Parturients undergoing elective Cesarean section under regional anesthesia were randomized to receive CSEA with either the double-space technique (double group, n = 20) or single-space technique (single group, n = 20). In the double group, an epidural catheter was inserted at the L1–2 interspace, and dural puncture was performed at the L3–4 interspace. In the single group, the procedure was performed at the L3–4 interspace using the needle-through-needle technique.Results: There were no differences in time to readiness or the intraoperative level of sensory block between the two groups. The postoperative sensory level was maintained higher in the double group (postoperative 1 h, P = 0.029; postoperative 6 h, P = 0.016). There was no difference between the two groups in side effects. The parturients’ satisfaction scores at 48 h postoperative were significantly different (9.5 in the double group vs. 8 in the single group, P = 0.004).Conclusions: We conclude that there were no differences in intraoperative variables between double -space technique and single space-technique for CSEA. However, double-space CSEA may be beneficial for postoperative pain control and parturients’ satisfaction scores of for Cesarean section.Trial registration: The study was registered at https://cris.nih.go.kr under the trial ID, KCT0002514, retrospectively registered. Date of registration: October 27, 2017.

scholarly journals Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section

2019 ◽  
Vol 47 (9) ◽  
pp. 4442-4453 ◽  
Author(s):  
Jing Sun ◽  
Zhao Zheng ◽  
Yi-Lu Li ◽  
Li-Wei Zou ◽  
Ge-Hui Li ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Epidural Anesthesia ◽  
Randomized Study ◽  
Saline Group ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Objective This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section. Methods A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention. Results The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C. Conclusion Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.

Acute Dystonia after a Single Dose of Intravenous Metoclopramide during Elective Cesarean Section: A Case Report.

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Danielle Levin
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Elective Cesarean Section ◽  
Single Administration ◽  
Dystonic Reaction ◽  
Elective Cesarean ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia.  During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron.  Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive.  Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds.  Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission. 

scholarly journals Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea

2021 ◽  
Vol 4 (1) ◽  
pp. 11-7
Author(s):  
Fritzky Indradata ◽  
Heri Dwi Purnomo ◽  
Muh. Husni Thamrin ◽  
Sugeng Budi Santoso ◽  
Ardana Tri Arianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Control Trial ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Duration Of Action ◽  
Significant Difference ◽  
Randomized Control

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea   Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

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