This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ithnin, F. Articles by Ocampo, C. E. Search for Related Content PubMed PubMed Citation Articles by Ithnin, F. Articles by Ocampo, C. E.

---

LETTER TO THE EDITOR

Combined Spinal Epidural Causes a Higher Level of Block than Equivalent, Single-Shot Spinal Anesthesia in Elective Cesarean Patients

Department of Women’s Anesthesia; KK Women’s and Children’s Hospital; Singapore; yvel6{at}hotmail.com

In Response:

As noted by Geeta et al., (1) our study (2) showed that the combined spinal epidural technique conferred a higher sensory block than the single spinal shot technique for parturients undergoing elective cesarean delivery. The mechanism suggested in our article, loss of negative pressure in the epidural space, is speculation. The letter from Geeta et al. suggests a possible study: if removing the stylet of a spinal needle while the tip is in the epidural space produces a higher block, this would add to the evidence (3,4) supporting our conjecture.

REFERENCES

1. Geeta, Katyal S, Mittal RK. A combined spinal epidural causes a higher level of block than equivalent, single-shot spinal anesthesia in elective cesarean patients. Anesth Analg 2007;104:745–6.[Free Full Text]
2. Ithnin F, Lim Y, Sia AT, Ocampo CE. Combined spinal epidural causes higher block than equivalent single shot spinal anesthesia in elective cesarean patients. Anesth Analg 2006;102:577–80.[Abstract/Free Full Text]
3. Goy RW, Sia AT. Sensorimotor anesthesia and hypotension after subarachnoid block: combined spinal-epidural versus single-shot spinal technique. Anesth Analg 2004;98:491–6.[Abstract/Free Full Text]
4. Goy RW, Chee-Seng Y, Sia AT, et al. The median effective dose of intrathecal hyperbaric bupivacaine is larger in the single-shot spinal as compared with the combined spinal-epidural technique. Anesth Analg 2005;100:1499–502.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ithnin, F. Articles by Ocampo, C. E. Search for Related Content PubMed PubMed Citation Articles by Ithnin, F. Articles by Ocampo, C. E.