Journal of AdvancedMedical and Dental Sciences Research

Background: Combined spinal epidural (CSE) is popular in modern anesthesia practice. The present study was conducted to compare sequential combined spinal epidural anesthesia versus epidural volume extension in lower limb orthopaedic surgery. Materials & Methods: 74 ASA class I or II patients aged 20–60 years old scheduled for lower limb orthopaedic surgery were divided into 2 groups of 37 each. Group I was sequential combined spinal epidural (SCSE) group and group II was Epidural volume extension (EVE) group. Hemodynamic parameters was recorded and compared. Results: Group I had 20 males and 17 females and group II had 18 males and 21 females. Duration of surgery was 124.2 minutes in group I and 126.8 minutes in group II. Anesthesia readiness time was 20.1 minutes in group I and 18.5 minutes in group II, modified Bromage motor score was 2 in group I and 1 in group II. Duration of motor block was 176.2 minutes in group I and 148.2 minutes in group II. Time for sensory regression to T12 was 134.2 minutes in group I and 124.2 minutes in group II. Supplementation with general anesthesia was 1 in group I and 4 minutes in group II, time to first request for postoperative analgesia was 232.6 minutes in group I and 192.1 minutes in group II. Number of patients who required pethidine was 8 in group I and 6 in group II and mean pethidine consumption (mg) was 4.3 mg in group I and 3.9 in group II. The difference was significant (P< 0.05). Conclusion: Both SCSE and EVE techniques is effective in patients undergoing lower limb orthopedic surgery.