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Anesthetic Management of Elderly Women Scheduled For Vaginal
Hysterecto
Tarek Mohammed Nagib1, Reda S. Abdelrahman1,
Ahmad A. Abdelhafez1 & Ibrahim A. Mordy Sayed2
Departments
of Anesthesia, Faculty of Medicine, Tanta1 & Al-Azhar2 Universities
Tanta Med. Sc. J 2008; 3(4):21-28
Article type: Original article
Aim: our study was designed to suggest a safe
regional anesthetic technique for elderly women undergoing vaginal
hysterectomy suitable for the duration of surgery, without the need
for general anesthesia. Patients & Methods: Twenty patients
scheduled for elective vaginal hysterectomy were randomly divided
into two groups, spinal group (SG) and combined spinal epidural
group (CSEG), with mean age (60.5±9.4, 63.2±3.6), respectively. In
SG 2.5 mL hyperbaric bupivacaine 0.5% were injected into the
subarachnoid space through 25-gauge spinal needle, in CSEG, 2.5mL
hyperbaric bupivacaine 0.5% were injected into the subarachnoid
space through 25-gauge spinal needle and bupivacaine 0.5% was
injected epiduraly through an epidural catheter, with a total volume
not exceeding 12:15mL. Results: The maximal sensory level achieved
in CSEG, was significantly higher than that in SG. (Median T3.6,
Maximum T3, minimum T4) versus (Median T5.5, Maximum T5, minimum T6)
P < 0.05. Time (minuets) taken for the block to recede to T10 was
significantly longer in CSEG compared with SG. (151.6±7.486) versus
(119.2±10.25) p < 0.05. Maximum decrease in systolic blood pressure
(%) was significantly higher in CSEG compared with SG, (22.4±5.9)
versus (16.9±5) P < 0.05. Conclusion: The combined spinal epidural
anesthesia provided a significantly higher level of sensory blockade
and longer time for the block to recede to T10, compared with spinal
anesthesia, which make CSE anesthesia the preferred technique to
avoid the need for general anesthesia in elderly women undergoing
vaginal hysterectomy.
ICID 881846 |