Efficacy of spinal-epidural anesthesia in elderly urologic patients

Abstract

Comparative efficacy of spinal anesthesia (SA), epidural anesthesia (EA) and spinal-epidural anesthesia (SEA) during surgery was studied in 72 urologic patients aged from 66 to 92 years. By the method of anesthesia the patients were divided into three groups: SA was used in group 1 (n = 24), EA - in group 2 (n = 27), SEA - in group 3 (n = 20). The efficacy of anesthesia was assessed by parameters of central hemodynamics, sensorial and motor characteristics. The results of the comparison of the anesthesia method showed that SEA combines advantages of EA and SA and is a useful technique for urologic geriatric surgery as it is characterized by a rapid onset, complete analgesia, absence of toxicity of local anesthetics, adequate muscle relaxation of the spinal block; catheterization of the epidural space extends the area of anesthesia, prolongs the time of anesthesia and provides continuous postoperative analgesia. No cases of postdural puncture headache were observed.