Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2010, Vol. 06 ›› Issue (01): 29 -32. doi: 10.3877/cma.j.issn.1673-5250.2010.01.110

Original Article

Application of Spinal-Epidural Anesthesia in Trans-Vaginal Hysterectomy

Hai-bing LI, Zhi-qing LIU, Yao HE, Yan HUAN, Yao SUN, Peng HU   

  1. Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China
  • Published:2010-02-01
Objective

To compare the anesthetic effects and hemodynamic changes between combined spinal-epidural anesthesia(CESA) and continuous epidural anesthesia (CEA) in trans-vaginal hysterectomy.

Methods

From January to September 2009, 80 patients who were underwent trans-vagina hysterectomy were randomly divided into two groups, CSEA group (n=40) and CEA group (n=40). Informed consent was obtained from all participates. There had no significant difference of the general situation between two groups(P>0.05). In CEA group, epidural anesthesia was established using (20-30) mL 2% lidocaine with epinephrine, whereas spinal anesthesia was performed using (2.0-3.0) mL hyperbaric 0.75% bupivacaine in CSEA group. The blood pressure, heart rate, SpO2 were monitored continuously during surgery. The changes of hemodynamic, anesthetic dosage, times of sensory block to T8, degrees of motor block and muscle relaxation, and postoperative headache were measured and analyzed.

Results

The mean arterial pressure(MAP) of CSEA group was significant lower than that of CEA group(P<0.05), times of sensory block to T8 was quicker in CSEA group than that of CEA group (P<0.01), anesthetic dosage of CSEA group was lower than that of CEA group (P<0.05), and muscle relaxation and motor block were much better in CSEA group (P<0.05).

Conclusion

Compared with continuous epidural anesthesia, combined spinal-epidural anesthesia is a perfect anesthetic option for trans-vaginal hysterectomy with smaller anesthetic dosages, quicker onset time and reliable muscle relaxation.

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[2] Ru-xia SHI, Su-fen LIU, Ye-ling XIE. Comparative Analysis of Pelvic Floor Reconstruction and Trans-Vaginal Hysterectomy in the Treatment of Pelvic Floor Dysfunction[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2011, 07(01): 34-38.
[3] Jin-ying LIU. The Exploration on the Practicability Value of Trans-Vaginal Hysterectomy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2008, 04(06): 571-574.
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