THE OSTIA VENAE HEPATICAE AND THE RETHROHEPATIC ...

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COMBINED SPINAL EPIDURAL ANESTHESIA VERSUS SPINAL
ANESTHESIA FOR CESAREAN SECTION ; EFFECT ON MATERNAL
HYPOTENSION, A RANDOMIZED, DOUBLE BLIND CONTROLLED
TRIAL
Neti T, Visalyaputra S, Pechpaisit N, Upatinkat K, Nakkuntod A, Chamadol S, Sakulpachareon
N
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.
Key words: anesthetic technique, combined spinal epidural, cesarean section
This study was designed to compare the effect of combined spinal epidural anesthesia
(CSEA) and spinal anesthesia on the incidence and severity of hypotension of patients undergone cesarean
section. Sixty term parturients, ASA class I-II were randomly divided into two groups. Regional
anesthesia was performed in right lateral, horizontal plane position. In Group I, spinal group, 2.0- 2.5 ml of
0.5% hyperbaric bupivacaine was given intrathecally. In group II, CSE group, 1.5- 2.0 ml of 0.5%
bupivacaine was given intrathecally and epidural lidocaine would be added if analgesic level was lower
than T 4 at 15 minutes after intrathecal injection or inadequate analgesia occurred during surgery. There
were no significant differences in the incidence and severity of maternal hypotension, ephedrine requirement,
maximal cephalad level of analgesia and analgesic level at 15 minutes after intrathecal injection
between the two groups. CSEA in right lateral, horizontal plane position has no advantages in term of
maternal hypotension during cesarean section as compared to spinal anesthesia.
(Thai J Anesth 1999; 25:192-200.)
IS I NTRA MUSCULAR PROMETHAZINE A PROPHYLACTIC
TREATMENT FOR EPIDURAL MORPINE- INDUCED PRURITUS IN
CESAREAN SECTION?
Vichitvejpaisal P, Ae-mornkun R, Mahaphan P, Napachoti T, Suksopee P
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.
Key words : epidural morphine, pruritus, promethazine
Faculty of Medicine Siriraj Hospital
Objectives. Our objective was to study the clinical effectiveness of promethazine in the
prevention of epidural morphine-induced pruritus in cesarean section. Methods. A prospective randomized
double-blind placebo-controlled study, 60 ASA I-II patients undergoing cesarean section under epidural
anesthesia with 15-25 ml of 2% lidocaine with 1: 200000 adrenaline. After the delivery of a newborn,
each patient were randomly devided into 2 groups to receive intramuscular injection of 1 ml normal
saline in placebo group and 25 mg of promethazine in promethazine group respectively. In the postoperative
period, the pruritus and nausea/vomiting were assessed every 2 hours for 48 hours. Twenty five mg
of oral diphenhydramine was also administered as required for the treatment of pruritus during the study.
Results. There was no statistically significant differences in the demographic data, the incidence and
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