Comparison of Spinal and Single Dose Epidural Anesthesia for Urological Procedures

KIRDEMİR P., Topal M. A. , Ozmen S., Altinisik U., Peker T. T.

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.29, no.2, pp.405-409, 2009 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 2
  • Publication Date: 2009
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.405-409


Objective: The aim of the study was to compare hemodynamic, analgesic and side effects of spinal and single dose epidural levobupivacaine + morphine for urogenital procedures. Material and Methods: 44 ASA I/II patients undergoing elective urological procedures were included in the study. Patients with cardiac disease, diabetes, bleeding or coagulation test abnormalities were excluded from the study. All the patients were premedicated with 5 mg diazepam. After preloading with NaCl 0.09% 10 mL kg(-1) patients were randomly allocated into two groups Group S had spinal puncture at L3-4/L4-5 intervertebral space using 25 gauge Quincke needle and received 10 mg levobupivacaine + 0.2 mg morphine HCI. Group E had epidural puncture at L3-4/L4-5 intervertebral space using 18 gauge Toughy needle and received 75 mg levobupivacaine + 2 mg morphine HCI. Sensorial blockade was evaluated by pinprick test and motor blockade by bromage scale. Patients' heart rate (HR), mean arterial pressure (MAP), sensorial block onset time and two segment regression time, side effects and duration of the operation were recorded. Results: Demografically there were no significant differences between the groups. In group E two segment regression time and postoperative analgesia were longer than in the other group. In Group S 2 patients had nausea-vomiting, 6 had itching (4 did not need any medication), 1 had postoperative analgesia and in Group E 2 had nausea-vomiting who did not need any medication and 2 had hypotension. Conclusion: Single dose epidural may be good choice for short duration urological procedures since it causes no motor block, has a longer sensorial block period and no requirement for analgesia for postoperative 48 hours.