Background: Spinal anesthesia with the epidural volume extension provides the possibility of using small doses of local anesthetics and the low frequency of hypotension. However, the dose of the local anesthetic and the volume of normal saline for administration into the epidural space, remain unclear.
Objective: To study the influence of new techniques of spinal anesthesia with the epidural volume extension at the level of sensory block and hemodynamic in pregnant with concomitant cardiac pathology during cesarean section.
Methods: In an observational study were included 24 pregnant women with cardiac pathology. Women were divided into 3 groups, depending on the value of intra-abdominal pressure (lAP). Expansion of the epidural space was performed before spinal anesthesia. For spinal anesthesia we used heavy bupivacaine 0.5% (5.5 ± 0.1 mg). The volume of saline for administration into the epidural space depends on the level of lAP RESULTS: The average upper level of sensory block did not difer significantly in groups and amounted Th 2.1 ± 0.5, 95% C.I. 1.6-4.0 (p = 0.001). The only one woman in group 3 (4.1%) developed hypotension. The maximum level of motor block (Bromage score) among the groups was similar and amounted to 1.5 ± 0.2, 95% C.I. 1.0-2.0 (p < 0.001).
Conclusions: The new technique of spinal anesthesia with the epidural extension provides qualitative analgesia and stable hemodynamics in pregnant women with concomitant cardiac pathology