A COMPARITIVE EVALUATION BETWEEN COMBINED SPINAL EPIDURAL BLOCK AND EPIDURAL BLOCK FOR LOWER ABDOMINAL SURGERIES

Abstract

Introduction: Most of the lower abdominal surgeries are conducted under spinal or epidural anaesthesia. The purpose of this study is to evaluate combined spinal epidural anesthesia and epidural block in terms of efficacy, surgical analgesia and muscle relaxation in patients undergoing lower abdominal surgeries. Material and methods: This prospective randomised study was conducted at SKMCH, Muzaffarpur, Bihar where 60 patients of ASA I and II, aged 20-60 years of both sexes scheduled for elective lower abdominal surgeries were randomized into two groups. Group A – receiving epidural anaesthesia. 20ml of 0.5% plain bupivacaine was injected epidurally.1.5-2ml of 0.5% Bupivacaine was injected epidurally for every unblocked segment after the maximum height of block is reached so as to get the required T6 level. Group B – receiving combined spinal epidural anaesthesia. (2.5 ml) of 0.5% Bupivacaine (heavy) was deposited in the subarachnoid space.1.5-2ml of 0.5% bupivacaine was injected epidurally for every unblocked segment after 10 minutes to get required T6 height of block. Results: The changes in hemodynamic parameters observed between the two groups are statistically not significant. The time to achieve T6 sensory block was significantly shorter in CSE group when compared to epidural group. CSEA provided more degree of motor blockade and significantly good quality of analgesia compared to epidural anesthesia alone. The amount of bupivacaine required to produce the desired level of T6 blockade is 2.5 times less in CSEA compared to epidural anesthesia. Conclusion: Combined spinal epidural technique is effective, safe, with stable hemodynamics and superior to epidural anaesthesia in patients undergoing lower abdominal surgeries.