경막외척수병용마취에서 Needle Through Needle 방법과 Double Segmental 방법의 비교

Abstract

Background: The combination of spinal and epidural anesthesia provides an efficient and profound anesthesia for surgery. There are needle through needle technique (NTN) and double segmental technique (DST) for combined spinal and epidural anesthesia (CSE). Some reports have differences about both techniques. We compared both techniques. Method: 87 patients were randomized to receive CSE by NTN (n=43) or DST (n=44). We measured procedure time, the numbers of attempted epidural punctures, epidural catheterizations, spinal punctures, and changes of operators. And we investigated success of spinal block and complications (the number of migrations of epidural catheter tip, headache, lumbar backache, postoperative nausea and vomiting and inadvertant dura puncture) of both techniques. Results: The number of attempted spinal punctures in NTN group is 1.4±0.9, which is smaller than 1.8±1.4 in DST group, The others are no difference significantly in NTN and DST groups. Conclusion: We find NTN and DST for CSE are no differences significantly in the technical problems and complications. We suggest the choice of NTN or DST for CSE is dependent on the skillfullness by operator.