• Der Anaesthesist · Nov 1997

    Randomized Controlled Trial Comparative Study Clinical Trial

    [Continuous spinal anesthesia vs. combined spinal-epidural anesthesia in emergency surgery. The combined spinal-epidural anesthesia technique does not offer an advantage of spinal anesthesia with a microcatheter].

    • S Wilhelm and T Standl.
    • Abteilung für Anästhesiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.
    • Anaesthesist. 1997 Nov 1;46(11):938-42.

    UnlabelledIn this prospective study we investigated the efficacy of microcatheter spinal anaesthesia in comparison with a combined spinal-epidural technique in trauma patients.MethodsAfter institutional approval 60 patients undergoing urgent lower-limb surgery randomly received either CSA (22 G Sprotte needle, 28 G nylon catheter) in group 1 or CSE (18 G Tuohy needle, 22 G epidural catheter and 25 G pencil-point needle) in group 2. An initial subarachnoid bolus of 2 ml of plain bupivacaine 0.5% was injected in both groups. Difficulties with the lumbar puncture or catheter insertion, the time required for performance of either technique and the onset of analgesia at T12 were documented. If analgesia did not reach T12 within 20 min, supplemental bupivacaine was injected either intrathecally or epidurally up to a maximum of 5 ml in the CSA group or 16 ml in the CSE group.ResultsThe number of lumbar punctures (CSA: n = 1.8 +/- 1.5; CSE: n = 2.6 +/- 1.8; P = 0.05) and the incidence of technical problems (CSA: 13%, CSE: 47%; P = 0.012) was higher in the CSE group. In contrast to CSA, performance of CSE was more time consuming (CSA: 8 +/- 3 min, CSE: 15 +/- 8 min; P = 0.0003), and the total dose of local anaesthetics was higher in the CSE group (CSA: 3.2 +/- 1 ml, CSE: 9.7 +/- 5 ml; P < 0.0001).ConclusionsBecause of the higher incidence of technical problems, more time was required for the performance of CSE. As a consequence, microcatheter CSA might be preferred over CSE in trauma patients.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.