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2007, Number 4

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Rev Mex Anest 2007; 30 (4)

Clinical experience of mixed blockade with continuous postoperative analgesia and epidural blockade with intravenous postoperative analgesia in caesarean section

Sarmiento-Ramírez NL, Hernández-Jiménez A

Language: Spanish
References: 22
Page: 216-219
PDF size: 109.75 Kb.


ABSTRACT

Background: The combined technique for obstetric patients undergoing caesarean section had been used for up to 20 years. Objective: To ascertain the efficacy of combined spinal-epidural block in caesarean section with postoperative pain control with synthetic opioids during the first 24 hours after surgery compared with the epidural technique and intravenous analgesia with metamizole. Methods: A randomized clinical study was conducted with two groups of patients with ASA I-II; group 1 (n=51) procedure was combined spinal-epidural with heavy bupivacaine for the surgery and buprenorphine and 0.125% bupivacaine for postoperative analgesia. Group 2 procedure was epidural technique (n = 49) with lidocaine for the surgery and intravenous metamizole for postoperative analgesia. The intensity of pain was evaluated by using an analogous visual scale (AVS) method during 24 hours; side effects were ascertained as well. Results: A good quality of anesthesia was obtained; this was evaluated by latency, need of potent analgesic during the surgery and time to begin the surgery. The latency time showed a Student t test value of 3.11 (p‹ 0.001), while the time to begin the surgery registered a Student t test value of 0.73, with no significant p value. Post surgical pain evaluated through the AVS was statistically significant for group 1. Conclusions: For obstetric patients the combined spinal-epidural technique with the spinal catheter for postoperative analgesia with selective analgesics drugs is a suitable option, when compared against the epidural technique and intravenous analgesic drugs.


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