Özal, Hasan Bursa Devlet Hastanesi - Anesteziyoloji ve Reanimasyon Kliniği, Turkey , Gürsoy, Sinan Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kol, İclal Özdemir Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kaygusuz, Kenan Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Düger, Cevdet Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Öztürk, Hayati Cumhuriyet Üniversitesi - Tıp Fakültesi - Ortopedi ve Travmatoloji Anabilim Dalı, Turkey , Mimaroğlu, Caner Cumhuriyet Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey

Continuous spinal and combined spinal-epidural anesthesia in the lower extremity surgery

33057

Aim. In this study, it was aimed to compare the effects of the continuous spinal anesthesia and the combined spinal-epidural anesthesia by using 0.5 % bupivacaine + morphine on peroperative analgesia quality, hemodynamic stability, block level, complications and postoperative analgesia quality in surgery of the lower extremity. Method. Fifty-four, ASA I-III patients included the study and divided into the two groups randomly. In the first group (n=27), a spinal catheter was placed into the intrathecal space and 10 mg 0.5 % bupivacaine + 0.1 mg morphine/2.5 mL were administered. In the second group (n=27), 5 mg 0.5% bupivacaine + 0.05 mg morphine/2.5 mL were administered intrathecal space and 30 mg 0.5% bupivacaine + 2 mg morphine/10 mL were administered into the epidural space. The time of the both procedures, systolic blood pressure, diastolic blood pressure, heart rate, bromage, sensorial block level, visual analog scale, verbal point scale values, patient’s satisfaction, additional dose necessity and overall doses were recorded for all patients. Results. There was no significant difference between the groups in point of application time of the method and operation time. While there was no difference between the groups in point of hemodynamic parameters, level of motor block, level of the sensorial block and patient’s satisfaction, the drugs consumption was higher in the combined spinal epidural anesthesia group (P 0.05) in the intraoperative period. In the postoperative period, while the analgesic effects of the both groups were similar, necessity of the additional dose and the itch incidence were higher in the combined spinal epidural anesthesia group (P 0.05). Conclusion. In conclusion, we decided that one method has not superiority over the other method in the intraoperative and postoperative periods.

324

Continuous spinal anesthesia , combined spinal epidural anesthesia , bupivacaine , morphine

Cumhuriyet Medical Journal

332