Background and objectives: We evaluated the effects of epidural injection with levobupivacaine or serum physiologic, epidural volume extension (EVE), when using combined spinal-epidural anesthesia (CSEA) for cesarean delivery. Methods: One-hundred and thirty-eight patients with a full-term pregnancy of 37-42 weeks that were scheduled for cesarean delivery were included. Group 1 (n. =. 48) received single-shot spinal anesthesia (SSS), group 2 (n. =. 45) received CSEA-EVE with saline, group 3 received CSEA-EVE with levobupivacaine. The characteristics of motor and sensory block, the effects on maternal hemodynamic changes and the effects on the newborn were compared. Results: Time to reach maximum sensory block was significantly shorter in groups 3 than in group 1 and 2 (p. <. 0.05). Two-segment regression time of sensory block was significantly shorter in group 1, whereas it was significantly longer in group 3 than in group 2 (p. <. 0.05). Time to onset of motor block was significantly longer in group 1 than in groups 2 and 3 (p. <. 0.05). Time to reach maximum motor block was significantly shorter in group 3 than in groups 1 and 2 (p. <. 0.05). Time to recovery of motor block was significantly longer in group 3 than in groups 1 and 2 (p. <. 0.05). The time to first analgesic was significantly longer in group 3 (p. <. 0.05). Conclusions: Sufficient and rapid motor and sensory block was achieved in all the patients in the present study; however, motor and sensory block had faster onset, lasted longer, and was of a higher level in groups 2 and 3; these effects were more pronounced in the group 3. © 2013 Elsevier Editora Ltda.
Salman, C., Kayacan, N., Ertuĝrul, F., Bigat, Z., & Karsli, B. (2013). Combined Spinal-Epidural Anesthesia with Epidural Volume Extension causes a Higher Level of Block than Single-Shot Spinal Anesthesia. Revista Brasileira de Anestesiologia, 63(3), 267–272. https://doi.org/10.1016/S0034-7094(13)70229-0