STUDY OF EFFECT OF INTERMITTENT EPIDURAL INJECTION OF NORMAL SALINE ON DURATION OF MOTOR AND SENSORY BLOCKADE AFTER COMBINED SPINAL EPIDURAL (CSE) ANAESTHESIA. A PROSPECTIVE, RCT

Deepak Bharat Kawade, Shubhada Rajendra Deshmukh, Noopur Borkar

Abstract


BACKGROUND: Prolonged motor and sensory block following Central Neuraxial Blockade (CNB) is associated with
extended postoperative immobilization and its complications. Speedy recovery from motor blockade would improve the
patients' acceptance of neuraxial anesthesia.
Previous studies in patients undergoing epidural anaesthesia, demonstrated rapid motor recovery after administration of epidural crystalloids.
We studied the effect of intermittent bolus injection of Normal saline (NS) on the duration of sensory and motor recovery after Combined spinal
epidural anaesthesia (CSEA).
METHODS:60 patients (ASA I-III) scheduled for surgeries under CSEA lasting for 1½ to 2 hrs were divided equally by systematic random
sampling at the end of surgery.
Control group - No bolus of NS flush was given through the epidural catheter.
Intervention group -15 ml of NS flush through epidural catheter was given thrice.
Sensory level, Motor blockade and vitals were noted at 5 min interval for 2 hours from end of surgery.
RESULTS:
1. Sensory levels in two groups were significantly different (p-value < 0.001) at the end of two hours. In intervention group, T8 level was
predominant, while in control group L1 level was predominant.
2. Difference in motor block in two groups was significant as (p-value < 0.001). In intervention group, 86.67% had Bromage score 0, while in
control group 80% had score 1 at the end of 2 hrs.
Conclusion: Postoperative epidural flush with 45 ml Normal saline hastened the motor recovery following CSEA without shortening of the
duration of sensory blockade.


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