A Comparative Study of Epidural Volume Extension Technique Versus Spinal Anaesthesia Using Hyperbaric Bupivacaine in Lower Abdominal and Lower Limb Surgeries

BACKGROUND Epidural Volume Extension technique (EVE) via a combined spinal epidural technique is the enhancement of small dose intrathecal block by epidural saline boluses. 1Epidural volume extension of a small dose spinal block can provide adequate anaesthesia for lower abdominal and lower limb surgeries, while allowing faster motor recovery of the lower limbs. 1 MATERIALS AND METHODSComparable groups of 30 each were given single shot intrathecal hyperbaric bupivacaine (Non-EVE Group) and other group was given epidural volume extension (EVE Group) by injecting 10 mL 0.9% saline via the epidural catheter.Groups were assigned by random number chart.Statistical analyses were performed using the SPSS version 9.0 for windows with Student's t-test, Mann-Whitney U-test and Chi-square test where appropriate.Statistical significance was assumed when p < 0.05. RESULTSThe peak sensory block was T6 to T10 (P < 0.000).The mean time for sensory loss regression to T10 (P < 0.002), reversal of Bromage score (P < 0.002) and post-operative complications like shivering (P < 0.000), nausea (P < 0.000) and vomiting (P <0.038) were significant statistically. CONCLUSIONWe found that epidural volume extension technique could be used for surgeries above the umbilicus (T10) for a longer duration with faster motor recovery and less post-operative recovery stay and complications; however, small sample size is a limitation to this study.