Advanced Search

Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 2005 November;71(11) > Minerva Anestesiologica 2005 November;71(11):701-9



A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2005 November;71(11):701-9



Comparison of sequential combined spinal-epidural anesthesia and spinal anesthesia for cesarean section

Brizzi A. 1, Greco F. 1, Malvasi A. 2, Valerio A. 1, Martino V. 2

1 Unit of Obstetric Anesthesia Casa di Cura S.Maria, Bari, Italy
2 Department of Obstetrics and Gynecology Casa di Cura S. Maria, Bari, Italy

Aim. The aim of our study was to prove that by using sequential combined spinal-epidural (CSE) anesthesia it is possible to overcome the limits connected to the use of spinal anesthesia (SA) alone for elective cesarean section.
Methods. We examined 100 women submitted to cesarean section; SA was administered to 50 patients and sequential CSE technique to the other 50. In every woman before execution of the anesthesia we infused, , 500 mL of a plasma expander and a previous administration of 5 mg of ephedrine. The CSE was executed at the L1-L2 intervertebral space, administering in spinal anesthesia 5 mg of levobupivacaine with 5 _g of sufentanil, and in peridural anesthesia 10-12 mL of levobupivacaine 0.25% according to the patient's height. The peridural catheter for postoperative analgesia was then positioned. In the group of women submitted only to SA, 7.5-8 mg of levobupivacaine was injected, according to the patient's height, in the L1-L2 intervertebral space, with 5 _g of sufentanil. We considered the following adverse effects: hypotension; bradycardia; vomiting; intraoperative discomfort and motor block.
Results. The results obtained showed that, with a P≤0.05, the incidence of motor block (P<0.001), discomfort (P<0.001) and hypotension (P=0.021) in the SA group is greater than in the CSE group. The difference in the incidence of vomiting (P=0.147) and bradycardia (P=0.067) between the 2 groups is not statistically significant.
Conclusion. In our opinion sequential CSE can be considered an important step forward in the regional anesthesia used for elective cesarean section.

language: English, Italian


top of page