A Randomized Double-Blind Comparison of the Double-Space Technique versus the Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section
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.
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Posted 09 Jan, 2020
Received 19 Jan, 2020
Received 09 Jan, 2020
On 07 Jan, 2020
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On 06 Jan, 2020
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Received 17 Dec, 2019
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On 28 Nov, 2019
On 20 Nov, 2019
A Randomized Double-Blind Comparison of the Double-Space Technique versus the Single-Space Technique in Combined Spinal-Epidural Anesthesia for Cesarean Section
Posted 09 Jan, 2020
Received 19 Jan, 2020
Received 09 Jan, 2020
On 07 Jan, 2020
On 06 Jan, 2020
Invitations sent on 06 Jan, 2020
On 06 Jan, 2020
On 05 Jan, 2020
On 05 Jan, 2020
On 22 Dec, 2019
Received 17 Dec, 2019
Received 17 Dec, 2019
Received 14 Dec, 2019
On 05 Dec, 2019
On 02 Dec, 2019
Invitations sent on 02 Dec, 2019
On 02 Dec, 2019
On 02 Dec, 2019
On 29 Nov, 2019
On 28 Nov, 2019
On 20 Nov, 2019
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