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A Randomized Double-Blind Comparison of the Double-Space Technique versus the Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section
Youn Jin Kim
Ewha Womans University, College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9189-5839
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Background: Combined spinal-epidural anesthesia (CSEA) can be performed with either a single-space technique or a double-space technique for cesarean section. We performed a double-blind randomized controlled study to compare the effect of the double-space technique with that of the single-space technique on sensory block level and side effects.
Methods: Parturients undergoing elective cesarean section under regional anesthesia were randomized to receive CSEA with either the double-space technique (double group, n = 20) or the single-space technique (single group, n = 20). In the double group, an epidural catheter was inserted at the L1–2 interspace, and dural puncture was performed at the L3–4 interspace. In the single group, the procedure was performed at the L3–4 interspace using the needle-through-needle technique.
Results: There were no differences in time to readiness or intraoperative level of sensory block between the two groups. The postoperative sensory level was maintained at a higher level in the double group than in the single group (1 h postoperatively, P = 0.029; 6 h postoperatively, P = 0.016). There was no difference between the two groups in terms of side effects. The parturient satisfaction scores 48 h postoperatively were significantly different between groups (9.5 in the double group vs. 8 in the single group, P = 0.004).
Conclusions: We conclude that there were no differences in intraoperative variables between the double-space technique and the single-space technique for CSEA. However, double-space CSEA for cesarean section may be beneficial for controlling postoperative pain and improving parturient satisfaction.
Trial registration: The study was retrospectively registered at https://cris.nih.go.kr under the trial ID KCT0002514. Date of registration: October 27, 2017.
Keywords
Cesarean section, Combined spinal-epidural technique, Obstetric anesthesia, Patient satisfaction, Regional anesthesia
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CURRENT STATUS: Under Review
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Posted 09 Jan, 2020
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Review #2 received
Received 19 Jan, 2020
Review #1 received
Received 09 Jan, 2020
Reviewer #2 agreed
On 07 Jan, 2020
Editor assigned
On 06 Jan, 2020
Reviewers invited
Invitations sent on 06 Jan, 2020
Reviewer #1 agreed
On 06 Jan, 2020
Submission checks complete
On 05 Jan, 2020
Editor invited
On 05 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 22 Dec, 2019
Review #3 received
Received 17 Dec, 2019
Review #2 received
Received 17 Dec, 2019
Review #1 received
Received 14 Dec, 2019
Reviewer #3 agreed
On 05 Dec, 2019
Editor assigned
On 02 Dec, 2019
Reviewers invited
Invitations sent on 02 Dec, 2019
Reviewer #1 agreed
On 02 Dec, 2019
Reviewer #2 agreed
On 02 Dec, 2019
Submission checks complete
On 29 Nov, 2019
Editor invited
On 28 Nov, 2019
First submitted
On 20 Nov, 2019
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Subject Areas
Anesthesiology & Pain Medicine
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This preprint is under consideration at BMC Anesthesiology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
A Randomized Double-Blind Comparison of the Double-Space Technique versus the Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section
Youn Jin Kim
Ewha Womans University, College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9189-5839
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 09 Jan, 2020
No community comments so far
Review #2 received
Received 19 Jan, 2020
Review #1 received
Received 09 Jan, 2020
Reviewer #2 agreed
On 07 Jan, 2020
Editor assigned
On 06 Jan, 2020
Reviewers invited
Invitations sent on 06 Jan, 2020
Reviewer #1 agreed
On 06 Jan, 2020
Submission checks complete
On 05 Jan, 2020
Editor invited
On 05 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 22 Dec, 2019
Review #3 received
Received 17 Dec, 2019
Review #2 received
Received 17 Dec, 2019
Review #1 received
Received 14 Dec, 2019
Reviewer #3 agreed
On 05 Dec, 2019
Editor assigned
On 02 Dec, 2019
Reviewers invited
Invitations sent on 02 Dec, 2019
Reviewer #1 agreed
On 02 Dec, 2019
Reviewer #2 agreed
On 02 Dec, 2019
Submission checks complete
On 29 Nov, 2019
Editor invited
On 28 Nov, 2019
First submitted
On 20 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Combined spinal-epidural anesthesia (CSEA) can be performed with either a single-space technique or a double-space technique for cesarean section. We performed a double-blind randomized controlled study to compare the effect of the double-space technique with that of the single-space technique on sensory block level and side effects.
Methods: Parturients undergoing elective cesarean section under regional anesthesia were randomized to receive CSEA with either the double-space technique (double group, n = 20) or the single-space technique (single group, n = 20). In the double group, an epidural catheter was inserted at the L1–2 interspace, and dural puncture was performed at the L3–4 interspace. In the single group, the procedure was performed at the L3–4 interspace using the needle-through-needle technique.
Results: There were no differences in time to readiness or intraoperative level of sensory block between the two groups. The postoperative sensory level was maintained at a higher level in the double group than in the single group (1 h postoperatively, P = 0.029; 6 h postoperatively, P = 0.016). There was no difference between the two groups in terms of side effects. The parturient satisfaction scores 48 h postoperatively were significantly different between groups (9.5 in the double group vs. 8 in the single group, P = 0.004).
Conclusions: We conclude that there were no differences in intraoperative variables between the double-space technique and the single-space technique for CSEA. However, double-space CSEA for cesarean section may be beneficial for controlling postoperative pain and improving parturient satisfaction.
Trial registration: The study was retrospectively registered at https://cris.nih.go.kr under the trial ID KCT0002514. Date of registration: October 27, 2017.
Figure 1
Figure 2