THE HEMODYNAMIC EFFECTS OF COMBINED SPINALEPIDURAL VERSUS SPINAL ANESTHESIA IN CESAREAN SECTION

Volume 12 , Issue 4 , December 2022 , Pages 345-351

Authors

Mohanned Wajeeh Saeed Zerary 1 ; Van Nasih Mohammed 2 ; Amir Murad Khudadad Boujan 3

1 Sulaimani Teaching Hospital, Ministry of Health, Kurdistan Region, Iraq.

2 Royal Hospital, Sulaimani. Ministry of Health. Kurdistan Region, Iraq.

3 College of the Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10378

Keywords

Abstract

Background
Hypotension and bradycardia are the main problems in parturients anesthetized with spinal anesthesia for
cesarean section. It is a common cause of maternal and fetal morbidity and mortality; the combined spinalepidural anesthesia technique is a new way to solve the problem.
Objectives
The hemodynamic effects of combined spinal-epidural anesthesia will be compared to spinal anesthesia alone
in cesarean section.
Patients and Methods
After the approval of the local ethical committee and taking patients’ consent, 100 parturients at Sulaimani
Maternity Hospital scheduled for cesarean section were involved in the study. They were divided into two
groups; group S (n_50) received (3ml) of bupivacaine in a single spinal shot technique. Group CSE (n_50)
received (2 ml) of the same drug with the insertion of an epidural catheter to give additional doses later in
a combined spinal-epidural technique. Blood pressure and pulse rate were measured regularly at 5 minutes
intervals throughout the operation. After shifting the patient to the ward, they continued the measurement
postoperatively for one hour with 15 minutes intervals.
Results
Hypotension was more common in group S in 42 cases versus 7 in the CSE group. It was significant (P=0.012).
Also, bradycardia occurred in 15 cases in the S group while it was only in 6 cases in the CSE group which
were significant (P = 0.008).
Conclusion
The maternal hemodynamic changes were less significant with the combined Spinal-Epidural technique
compared to routine spinal anesthesia of cesarean section.

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  • Published at21 December 2022

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