International Journal of Obstetric Anesthesia
Volume 15, Issue 1 , Pages 13-17 , January 2006

Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery

  • D.-H. Choi

      Affiliations

    • Corresponding Author InformationCorrespondence to: Duck Hwan Choi MD, Department of Anesthesiology and Pain Medicine, Samsung Medical Center, 50 ILwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea. Tel.: +82 2 3410 2466; fax: +82 2 3410 0361.
    • ,
  • H.-J. Ahn
    • ,
  • J.-A. Kim

,Accepted 1 May 2005.

References 

  1. Rout CC, Rocke DA. Prevention of hypotension following spinal anesthesia for cesarean section. Int Anesthesiol Clin. 1994;32:117–135
  2. De Simone CA, Leighton BL, Norris MC. Spinal anesthesia for cesarean delivery. A comparison of two doses of hyperbaric bupivacaine. Reg Anesth. 1995;20:90–94
  3. Riley ET, Cohen SE, Rubenstein AJ, Flanagan B. Prevention of hypotension after spinal anesthesia for cesarean section: six percent hetastarch versus lactated Ringer’s solution. Anesth Analg. 1995;81:838–842
  4. Akerman B, Arwestrom E, Post C. Local anesthetics potentiate spinal morphine antinociception. Anesth Analg. 1988;67:943–948
  5. Hunt CO, Naulty JS, Bader AM, et al. Perioperative analgesia with subarachnoid fentanyl-bupivacaine for cesarean delivery. Anesthesiology. 1989;71:535–540
  6. Ben-David B, Miller G, Gavriel R, Gurevitch A. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med. 2000;25:235–239
  7. Choi DH, Ahn HJ, Kim MH. Bupivacaine-sparing effect of fentanyl in spinal anesthesia for cesarean delivery. Reg Anesth Pain Med. 2000;25:240–245
  8. Vercauteren MP, Coppejans HC, Hoffmann VH, Mertens E, Adriaensen HA. Prevention of hypotension by a single 5-mg dose of ephedrine during small-dose spinal anesthesia in prehydrated cesarean delivery patients. Anesth Analg. 2000;90:324–327
  9. Rawal N, Schollin J, Wesstrom G. Epidural versus combined spinal epidural block for cesarean section. Acta Anaesthesiol Scand. 1988;32:61–66
  10. Thoren T, Holmstrom B, Rawal N, Schollin J, Lindeberg S, Skeppner G. Sequential combined spinal epidural block versus spinal block for cesarean section: effects on maternal hypotension and neurobehavioral function of the newborn. Anesth Analg. 1994;78:1087–1092
  11. Fan SZ, Susetio L, Wang YP, Cheng YJ, Liu CC. Low dose of intrathecal hyperbaric bupivacaine combined with epidural lidocaine for cesarean section–a balance block technique. Anesth Analg. 1994;78:474–477
  12. Vercauteren MP, Coppejans HC, Hoffmann VL, Saldien V, Adriaensen HA. Small-dose hyperbaric versus plain bupivacaine during spinal anesthesia for cesarean section. Anesth Analg. 1998;86:989–993
  13. Choi DH, Park NK, Cho HS, Hahm TS, Chung IS. Effects of epidural injection on spinal block during combined spinal and epidural anesthesia for cesarean delivery. Reg Anesth Pain Med. 2000;25:591–595
  14. Rawal N, Holmstrom B, Crowhurst JA, Van Zundert A. The combined spinal-epidural technique. Anesthesiol Clin North America. 2000;18:267–295
  15. Stienstra R, Dahan A, Alhadi BZ, van Kleef JW, Burm AG. Mechanism of action of an epidural top-up in combined spinal epidural anesthesia. Anesth Analg. 1996;83:382–386
  16. Blumgart CH, Ryall D, Dennison B, Thompson-Hill LM. Mechanism of extension of spinal anaesthesia by extradural injection of local anaesthetic. Br J Anaesth. 1992;69:457–460
  17. Choi DH, Kim DH. The ideal combination of spinal-epidural anaesthesia for Caesarean delivery. IMRAPT. 2001;13:A77
  18. Lew E, Yeo SW, Thomas E. Combined spinal-epidural anesthesia using epidural volume extension leads to faster motor recovery after elective cesarean delivery: a prospective, randomized, double-blind study. Anesth Analg. 2004;98:810–814
  19. Kuczkowski KM. Epidural test dose: a “gold standard”? Or a necessary evil?. Acta Anaesthesiol Scand. 2005;49:722
  20. Gaiser RR. The epidural test dose in obstetric anesthesia: it is not obsolete. J Clin Anesth. 2003;15:474–477
  21. Birnbach DJ, Chestnut DH. The epidural test dose in obstetric patients: has it outlived its usefulness?. Anesth Analg. 1999;88:971–972
  22. Albright GA, Forster RM. The safety and efficacy of combined spinal and epidural analgesia/anesthesia (6,002 blocks) in a community hospital. Reg Anesth Pain Med. 1999;24:117–125
  23. Cowan CM, Kendall JB, Barclay PM, Wilkes RG. Comparison of intrathecal fentanyl and diamorphine in addition to bupivacaine for caesarean section under spinal anaesthesia. Br J Anaesth. 2002;89:452–458
  24. Asokumar B, Newman LM, McCarthy RJ, Ivankovich AD, Tuman KJ. Intrathecal bupivacaine reduces pruritus and prolongs duration of fentanyl analgesia during labor: a prospective, randomized controlled trial. Anesth Analg. 1998;87:1309–1315

☆ This article was presented in part at 1st World Congress on Regional Anesthesia and Pain Therapy in Barcelona, Spain (2002). The abstract was published in the IMRAPT 2002;14:A129.

PII: S0959-289X(05)00105-6

doi: 10.1016/j.ijoa.2005.05.009

International Journal of Obstetric Anesthesia
Volume 15, Issue 1 , Pages 13-17 , January 2006

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