Comparison of Different Volumes of Normal Saline for Epidural Volume Extension in Combined Spinal Epidural Anesthesia for Lower Abdominal Surgeries

摘要

Context: Block augmentation by epidural volume extension has been adequately documented but therehave been not enough studies comparing different volumes of normal saline used in this technique toaugment the level of block achieved. The study compares different volumes of normal saline(5,10 and 20ml) for epidural volume extension in combined spinal epidural anaesthesia for lower abdominal surgeries.120 women, aged between 20-60 years belonging to ASA grade I-II undergoing elective lower abdominalsurgeries were included in this study. The patients were randomly allocated into 3 groups and each groupcomprised of 40 patients. GROUP 1(EVE 5) received 10 mg 0.5% bupivacaine heavy (H) intrathecallywith 5 ml normal saline through the epidural catheter as a part of Epidural volume extension. GROUP 2(EVE10) and GROUP 3 (EVE20) received 10 ml and 20 ml of normal saline as a part of Epidural volumeextension respectively in addition to the intrathecal drug. The patients were assessed for sensory blocklevel to loss of pain from pin prick and for motor block using Bromage scale. Peak sensory block height,highest Bromage score, time taken to achieve maximum sensory and motor block and the time to theirrecovery were recorded.Statstical Analysis. was done using statistical software SSPS version 16.0 andEpi- info version 6.0 .Outcome measures were presented as % for qualitative variables and mean±SD forquantitative variables.Demographic data and duration of surgery were similar in all the groups.Sensoryblock augmentation was found to be significantly higher in the EVE10 and EVE 20 groups. There was nodifference in the peak motor block score between the groups during the study. Time to achieve the blockswere significantly shorter for the 20 ml group than the 10 and 5 ml groups; the latter two being comparable.This was associated with a significantly faster motor recovery to Bromage 0 in groups EVE10 and EVE20.