Combined Sequential Spinal Epidural Anesthesia: A Prospective Study

Background: Aim of this prospective study was to evaluate the sensory block quality and hemodynamic effects in patients undergoing urologic surgery under Combined Sequential Spinal Epidural Anesthesia (CSSE). Methods: Fifty patients were included in the study. Inclusion criteria were age ≥ 18 years and surgery scheduled to last ≤ 2 hours. Patients with a history of hypertension, congestive heart failure, any active medication for cardiovascular disease or any other absolute or relative contraindication to spinal anesthesia were excluded from the study. Patients undergoing urologic procedures received CSSE with 4 ml of Levobupivacaine 0.075% intratecally, followed by 10 ml of Levobupivacaine 1.5% epidurally. Sensory block spread was assessed by a pin prick test. Cardiac index (CI), blood pressure (BP), heart rate (HR) and arterial saturation of O2 (SpO2) were continuously monitored and recorded. Before discharge, patient’s functional status was assessed by the Aldrete Score.