• Nian-yue Bai, Qu-lian Guo, and Yao Liu.
• Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, China.
• Hunan Yi Ke Da Xue Xue Bao. 2002 Dec 28; 27 (6): 539-41.

ObjectiveTo compare the anaesthetic effect and hemodynamic changes between the continuous spinal anaesthesia(CSA) and combined spinal-epidural anaesthesia (CSEA) in patients for uterectomy.MethodsSixty patients undergoing uterectomy were randomly divided into two groups: CSA group and CSEA group. Spinal anesthesia was performed at L2-3 interspace. An initial subarachnoid bolus of 0.5% hyperbaric bupivacaine 2 ml was injected in the CSA group; if analgesia did not reach T8, supplemental bupivacaine was injected by titrate incremental doses. In the CSEA group, epidural anesthesia was performed at T12-L1 with a catheter inserted into the epidural space for anesthesia maintenance, and then 0.5% hyperbaric bupivacaine 3 ml was injected to the subarachnoid at L2-3. The levels and times of sensory and motor block and hemodynamic changes were measured and analysed.ResultsThe anesthetic dosage of the CSA group was smaller than that of the CSEA group (group P < 0.05). The times of sensory block to T8 or the maximal level and motor block were more rapid in the CSEA group than those of the CSA group (P < 0.05). Mean arterial pressure (MAP), which decreased significantly, was related with the baseline in the two groups; the time was 15 min and 25 min in the CSEA group and CSA group respectively (P < 0.05). There was no difference in the maximum decline of MAP in the two groups (P < 0.01).ConclusionCSA is a safe technique of spinal anesthesia with small anesthetic dosages, more reliable and hemodynamically stable in patients for uterectomy.

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