Effect of epidural volume extension with 7.5 ml of normal saline on sensory block for caesarean section

Abstract

Spinal anaesthesia is considered the preferred anaesthetic technique for elective caesarean section as it avoids the risks of general anaesthesia related to difficult intubation and aspiration of gastric contents. Rescue strategies like changes in tilt of table are used to raise the level of an inadequate sensory block following intrathecal injection. This prospective, randomized, controlled study was conducted in 100 parturients, ASA1 or ASAII, with gestational age 38 weeks or more undergoing elective cesarean section under CSEA. Women were randomly distributed into two equal groups: Group A (CSE with no EVE), Group B (CSE followed by EVE using 7.5ml of normal saline). Time to reach maximum sensory block was significantly shorter in group B, Higher levels of sensory block were seen in group B (60% had T3-T4 block) whereas in group A, 64% had T5-T6 block. Group B and C had significantly higher levels of peak sensory block as compared to group A (p<0.001), two or more segments higher than the group A as assessed by temperature and pinprick. Two segment regression time of sensory block was significantly shorter in group A, whereas it was significantly longer in group B.