A Comparative Study Of Combined Spinal Epidural Anaesthesia Versus Epidural Anaesthesia For Elective Caesarean Section

ABSTRACT

Background and aims This study was done to compare the efficacy of combined spinal epidural(CSEA) anaesthesia with epidural anaesthesia based on the parameters such as onset time,quality of intraoperative analgesia, quality of motor blockade,incidence of hypotension and total local anaesthetic dose requirement Materials and methods– 50 patients undergoing elective LSCS were divided into two groups of 25 each .One group received combined spinal epidural anaesthesia(CSE). The other group received epidural anaesthesia.The combined spinal epidural (CSE) group received 1 ml of 0.5% hyperbaric bupivacaine intrathecally followed by 10 ml of 0.5% plain bupivacaine with adrenaline 5mcg/ml (1 in 2,00,000) epidurally. The epidural group patients received 16 ml of 0.5% plain bupivacaine with adrenaline epidurally. Study parameters were noted. Observation and results In CSE group 72% achieved complete anaesthesia ,while in epidural group only 40% achieved complete anaesthesia which is statistically significant.(p<0.05)Complete motor blockade was achieved in 68% in CSE group and 36% in Epidural group.Incidence of hypotension was similar in both groups.Mean local anaesthetic dose was 55 mg in CSE group compared to 86mg in the epidural group which was statistically significant. Conclusion Combined spinal epidural anaesthesia offers rapid onset of intense neuraxial blockade, better muscle relaxation, better intraoperative analgesia and decrease in the total requirement of local anaesthetic dose when compared with epidural anaesthesia in elective caesarean section.