Abstract:

INTRODUCTION: The aim of this study is to determine the complications of spinal, epidural and combined spinal-epidural anaesthesia in patients who received elective surgery METHODS: In this study, 113 patients, 18-60 years of age and ASA I-II, were randomized into 3 groups. Before regional anaesthesia, crystalloid solutions (10 ml/kg IV) were administered to patients for hydration and midazolam (0.03 mg/kg IV) for sedation. For spinal anaesthesia (Group S) hyperbaric bupivacaine (% 0.5 15 mg) was used. For epidural anaesthesia (Group E), 70 mg levobupivacaine and 100 mcg fentanyl were used. In combined spinal-epidural anaesthesia, 10 mg levobupivacaine and 50 mcg fentanyl for spinal anaesthesia, 35 mg levobupivacaine and 50 mcg fentanyl for epidural anaesthesia were used. Sensory block and motor block levels were evaluated by “Pin-Prick” test and “Bromage” scale respectively. Before regional anaesthesia, after regional anaesthesia and end of the surgery, the parameters SAP, DAP, MAP, HR were recorded at every 5 minutes. Peroperative and postoperative neurological complications (paraplegia, cauda equina syndrome, radiculopathy), hemodynamic complications (hypotension, syncope, bradycardia, cardiac arrest), back pain, headache, findings of infection (local, meningitis), tinnitus, metallic taste, itching were recorded. At the end of surgery, the duration of surgery was recorded. RESULTS: While comparisons between age, ASA and operation times of groups revealed significant differences, distribution of demographic values were similar. Comparison between SAP before regional anaesthesia, and 30., 40., 50. and 60. min -DAP, MAP before regional anaesthesia, and 70., 60., and 70. min- HR values of groups were found significant (p<0.05). Rates of complications in the spinal anaesthesia group were headache (11.6 %), back pain (2.3 %), nausea-vomiting (9.3 %), bradycardia (4.7 %), itching (2.3 %), while in the epidural anaesthesia group back pain (5.3 %), bradycardia (2.6 %), and itching (34.2 %) were detected in indicated frequencies.The corresponding frequencies of these latter complications in the combined spinal-epidural anaesthesia group.were 6.3, 6.3, and 14.2 %, respectively. DISCUSSION AND CONCLUSION: In this study several complications of central blocks such as headache (4.4 %), back pain (4.4 %), nausea and vomiting (3.5 %), bradycardia (4.4 %) and itching (14.2 %) were observed.

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