Abstract:

Objective To assess the efficacy and safety of combined spinalepidural anesthesia with needle opening in different directions for cesarean section before and after the skin insician was made. Vital signs, drug use, sensory block onset time, anesthesia time, the level of nerve blockage and the impact of skin incision were compared.
Methods Totally 210 cases who underwent routine elective caesarean section were enrolled into this study. They were divided into two groups according to the direction of spinal anesthesia clock port, group A with the inclined plane of the needle tip opening to the head(112 cases) and group B to the cauda(98 cases). After injection of the anesthetics with the pregnant women in lateral decubitus position, they were kept in left oblique 30° position.
Results The vital signs changed significantly(P<0.01) one minute after injection in group A as compared to group B and the left lateral position could not result in significant improvement, the majority of the cases in group A needed medication to improve the vital signs. There were no significant differences in time to skin incision as well as the onset time of sensory block(P>0.05).
Conclusion In combined spinal and epidural anesthesia for cesarean section, the inclined plane of the spinal anesthesia needle tip opening to the direction of cauda of the patient had little influence on the vital signs, medication risk reduction in caesarean section. Therefore, this method may be a better one in anesthesia for caesarean section.

Key words: subarachnoid anesthesia, cesarean section, direction of needle tip opening