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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objective The aim was to compare low-dose combined spinal-epidural and conventional epidural anesthesia for elective cesarean section in patients with severe preeclampsia. Background Severe preeclampsia endangers the life of the mother and/or the fetus through decreasing the blood flow to the placenta, leading to growth retardation, low birth weight, preterm birth, breathing difficulties to the newborn, placental abruption, heavy bleeding, HELLP syndrome, eclampsia, cerebrovascular stroke or hemorrhage, pulmonary edema, renal failure, liver failure, and disseminated intravascular coagulopathy, and also it may end up in death. Patients and methods This study included 60 patients with severe preeclampsia undergoing elective cesarean section. They were divided into two groups: group I received low-dose combined spinal-epidural anesthesia, with 7 mg of 0.5% heavy bupivacaine with 25 μg of fentanyl intrathecally and incremental doses of 3–5 ml of plain bupivacaine in the epidural catheter 10–15 min after the intrathecal injection, and group II patients received conventional epidural anesthesia, with 16 ml of 0.5% plain bupivacaine (after 4 ml of lidocaine 2% as a test dose). Results There was no statistically significant difference between the two studied groups regarding the mean arterial pressure, the heart rate, and the oxygen saturation of the mother; the umbilical cord measurements; and APGAR score of the fetus at different time points. Conclusion The use of low-dose combined spinal-epidural anesthesia for elective cesarean section in patients with severe preeclampsia seems to be as safe and efficient with the same better outcome for the mother and the fetus as conventional epidural anesthesia.

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