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Research Paper | Anaesthesiology | Egypt | Volume 10 Issue 3, March 2021
Low Dose Combined Spinal-Epidural Anesthesia Versus Conventional Epidural Anesthesia for Elective Cesarean Section in Severe Preeclampsia
Mamdouh E. Lotffy | Ayman A. Radi | Dr. Nevine M. Soliman | Dr. Khaled M. Gaballah | Amir R. Youssef
Abstract: Background: Severe preeclampsia is a critical situation which endangers the life of the mother & /or the fetus through decreasing the blood flow to the placenta leading to slow growth, growth retardation, Low birth weight, preterm birth & breathing difficulties to the new born; placental abruption & heavy bleeding, HELLP syndrome (Hemolysis, Elevated Liver Enzymes & Low Platelet count), Eclampsia (preeclampsia plus seizures), cerebrovascular stroke or hemorrhage, pulmonary oedema, renal failure, liver failure, disseminated intravascular coagulopathy & it may end by death. The aim of this study was to compare low dose Combined spinal epidural & conventional epidural anesthesia for elective cesarean section in patients with severe pre-eclampsia as regards safety, efficacy & the best outcome. Methods: Our study included sixty patients with severe preeclampsia undergoing elective cesarean section and they were divided into two groups with thirty patients in each group; GroupI received low dose combined spinal epidural anesthesia under aseptic precautions using 7mg 0.5 %heavy bupivacaine with 25micograms fentanyl intrathecal and incremental doses of 3-5 ml plain bupivacaine in the epidural catheter after10-15 minutes of the intrathecal injection while patients in group II received conventional epidural anesthesia using 16ml 0.5 % plain bupivacaine (after 4ml of lidocaine2 % as a test dose) the 16ml of plain bupivacine 0.5 % were given over 3minutes. Results: In our study, there was no statistical significant difference between the two studied groups regarding the mean arterial pressure, the heart rate & the oxygen saturation (SaO2) of the mother & the umbilical card measurements and APGAR score of the fetus at different time points. Conclusion: The use of low dose combined spinal epidural anesthesia for elective cesarean section in patients with severe pre-eclampsia is as safe, efficient with the same good outcome to the mother & the fetus as conventional epidural anesthes
Keywords: Combined Spinal-Epidural Anesthesia, Conventional Epidural Anesthesia, Cesarean, Preeclampsia
Edition: Volume 10 Issue 3, March 2021,
Pages: 1567 - 1572