• Sarmila Guha Banerjee, Ujjwal Bandyopadhyay, Pradyut Kumar Pan, and Arijit Sinha.
• Department of Anaesthesiology, West Bengal Health Service, Howrah District Hospital, Bankura, India.
• Anesth Essays Res. 2014 Jan 1; 8 (1): 54-8.

AimsThe aim of the present study is to substantiate and compare the quality and extent of nerve block by using intrathecal bupivacaine or extradural bupivacaine alone and in combined spinal-epidural (CSE) technique using smaller dose of intrathecal bupivacaine and extradural injection of a smaller dose of bupivacaine or normal saline.Setting And DesignA prospective study design was set up with 60 adult patients scheduled for vaginal and lower abdominal operation under CSE technique and single spinal or epidural technique.Materials And Methods60 patients undergoing infra-umbilical surgery were divided into three groups (Group). Group A1 (control) 10 patients received 3 ml of intrathecal heavy bupivacaine. A2-10 patients received 16 ml isobaric bupivacaine extradurally Group B (n = 20) patients received 2 ml intrathecal heavy bupivacaine and 10 ml normal saline extradurally. Group C patients (n = 20) received 2 ml heavy bupivacaine intrathecally and 10 ml isobaric bupivacaine extradurally. A total duration of this study was 18 months. Duration of motor block, sensory block, analgesia, onset of sensory block and cephaloid extent of sensory block and side-effects noted among patients. Visual analog scale in the post-operative period was recorded.Statistical AnalysisThe results were analyzed statistically by applying analysis of variable, odds ratio and Chi-square test.ResultsPatients were comparable regarding the onset time and height and duration of sensory block with a significant difference, though there was no difference in duration of motor block and analgesia. The side-effects in the control group are higher than the other two groups.ConclusionQuality of nerve block in combined technique using bupivacaine both intrathecally and extradurally is better and associated with lower side-effect compared with intrathecal heavy bupivacaine or extradural isobaric bupivacaine alone.

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