Journal of AdvancedMedical and Dental Sciences Research

Background: Sequential combined spinal epidural (SCSE) is a modified method of anesthesia in which a small spinal dose inadequate for surgery is used in an attempt to decrease incidence of hypotension and the block is then extended cephalad with the epidural drug. The present study compared sequential combined spinal epidural anesthesia versus epidural volume extension in lower limb orthopaedic surgery. Materials & Methods: 80 ASA class I or II patients scheduled for lower limb orthopaedic surgerywere divided into 2 groups of 40 each. Group I was sequential combined spinal epidural (SCSE) group and group II was epidural volume extension (EVE) group. Parameters such as anesthesia readiness time, modified bromage motor score, duration of motor block, time for sensory regression to T12, supplementation with general anesthesia, time to the first request for postoperative analgesia, number of patients who required pethidine and mean pethidine consumption was recorded in both groups. Results: Group I had 22 males and 18 females and group II had 19 males and 21 females. Duration of surgery was 128.2 minutes in group I and 122.8 minutes in group II. Anesthesia readiness time was 21.1 minutes in group I and 19.5 minutes in group II. Duration of motor block was 178.2 minutes in group I and 150.2 minutes in group II. The mean modified bromage motor score was 2 in group I and 1 in group II. The difference was significant (P< 0.05). Time for sensory regression to T12 was 136.2minutes in group I and 125.2 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 230.6 minutes in group I and 194.1 minutes in group II. Number of patients who required pethidine was 7 in group I and 5 in group II and mean pethidine consumption (mg) was 4.7 mg in group I and 3.6 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.