The effect of epidural top-up technique with saline in combined spinal-epidural anesthesia: a prospective study

Aim: To investigate the influence of saline injection as an epidural top-up on sensory block characteristics in combined spinal-epidural anesthesia.Materials and methods: A group of 50 patients scheduled for transurethral prostate resection surgery received a subarachnoid 10 mg of 0.5% hyperbaric bupivacaine and were randomly allocated to 1 of 2 groups. Patients in Group S received 10 mL of epidural saline 5 min after spinal block, and those in Group C did not receive anything via epidural catheter. The sensorial block level, motor block degree, and hemodynamic variables were recorded at 5 min intervals. The time to S1 segment regression of sensorial block and complete recovery of motor block were also recorded.Results: Sensorial block level was significantly higher in Group S than Group C at 15, 20, and 30 min (P 0.05). Time to S1 segment regression, time to complete recovery of motor block, and hemodynamic data were similar between the 2 groups.Conclusion: Saline injection via epidural catheter as an epidural top-up provided an increase in sensory block level in combined spinal-epidural anesthesia without changing the hemodynamic data or the time to complete recovery from sensorial and motor block.