Key result
Epidural volume extension with 10 ml of normal saline significantly reduced the time of onset of sensory block (2.08 vs 3.22) and increased the maximum height of sensory block.
Why the study?
The study was conducted to evaluate the effect of epidural volume on the time of onset of sensory blockade and the maximum height of the sensory block achieved in spinal anesthesia.
Does epidural volume extension with 10 ml normal saline improve the onset and height of sensory block in patients undergoing gynaecological surgery?
RCT (n=100)
Randomized
Does epidural volume extension with 10 ml normal saline improve the onset and height of sensory block in patients undergoing gynaecological surgery?
Absolute Event Rate: 2.08% vs 3.22%
Epidural volume extension with 10 ml of normal saline following spinal anesthesia accelerates the onset and increases the height of sensory block with minimal hemodynamic changes.
BACKGROUND: The epidural volume extension (EVE) technique is a modication of Combined Spinal Epidural Anesthesia (CSEA) in which the level of sensory analgesia obtained via subarachnoid block (SAB) is increased by a small volume of saline or local anaesthetic (LA) administered into epidural space through the epidural catheter. OBJECTIVE OFTHE STUDY: To study the effect of epidural volume on the time of onset of sensory blockade and the maximum height of the sensory block achieved in spinal anesthesia. MATERIALS AND METHODS: A prospective randomized study of 100 patients belonging to ASA physical status I & II. A pre-anesthetic evaluation and clinical examination with baseline investigations like CBC, urine routine, CXR, blood sugars, RFTand ECG were done. Patients were randomly allocated into 2 groups of 50 each. Group S(control) received 3 ml of 0.5% Bupivacaine (H) injection intrathecally. Group E(study) received 10 ml of Normal Saline epidurally immediately after spinal anesthesia with 3 ml of 0.5% Bupivacaine (H). The time of Onset of sensory blockade, maximum height of sensory block, hemodynamic status and adverse effects if any were compared in both the groups. RESULTS: The time of onset of sensory block was signicantly lower in Group E (2.08 ±0.77) than Group S (3.22±0.84). The maximum height of sensory block attained by Group E was T1 (18%) while that in Group S was T2 (6%). Maximum no of patients (36%) in group E attained a sensory level of T2 whereas in Group S, maximum no. of patients (40%) attained a sensory height of T6. Hemodynamic changes were not much different in patients of both the groups. The side effect was less in Group S as compared to Group E. CONCLUSION: We concluded that EVE of 10 ml of 0.9% saline with 3 ml of intrathecal 0.5% bupivacaine(H) fastens the onset and increases the height of sensory block with minimal hemodynamic changes.
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S et al. (2021) conducted an RCT in Gynaecological surgery (n=100). Epidural volume extension (EVE) with Normal Saline vs. Spinal anesthesia alone (3 ml of 0.5% Bupivacaine intrathecally) was evaluated on Time of onset of sensory block. Epidural volume extension with 10 ml of normal saline significantly reduced the time of onset of sensory block (2.08 vs 3.22) and increased the maximum height of sensory block.
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