Low-dose combined spinal epidural versus general anaesthesia for elective caesarean delivery: a comparative study

ABSTRACT

Combined spinal epidural [CSE] technique has allowed intrathecal doses of local anesthetic to be greatly reduced. Although regional anaesthesia is the preferred anaesthetic technique for caesarean section, general anaesthesia is still required in certain situations. The present study was designed to compare intraoperative haemodynamics, total ephedrine consumption, blood loss and postoperative analgesia of low-dose combined spinal epidural anesthesia with general anesthesia for uncomplicated elective caesarean delivery. Sixty ASAI parturients, with gestational age>36weeks with intrauterine single fetus scheduled for elective caesarean delivery. Patients were classified into 2 equal groups. Group 1 Low-dose Combined SpinAl Epidural Anaesthesia group [CSE]. Patients received subarachnoid 0.5% hyperbaric bupivacaine 6 mg mixed with fentanyl 20 micro g, and epidural 0.25% bupivacaine 10 mL. Group 2 General Anaesthesia group [GA]. Patients were induced by propofol, succinyl choline and atracurium with 50% nitrous oxide in oxygen and isoflurane 0.75%. After fetal delivery fentanyl was injected 1A micro g/kg, with with 60% nitrous oxide in oxygen and isoflurane 0.5%. There were nonsignificant differences regarding demographic data. Haemodynamic measurements showed nonsignificant changes in group1, while showed a significant increase in MABP and HR after induction and during extubation. There was a significant increase in total ephedrine consumption in group 1, while there was significant increases in blood loss, total amount of morphine consumption and VAS score in group 2. We conclude that low-dose combined spinal epidural anaesthesia is preferred to general anaesthesia for elective uncomplicated caesarean delivery with regard to haemodynamics, intraoperative blood loss and postoperative analgesia