الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pic-eclarnptic patients present a challenge to the anesthetist because of the problems ihat preeclampsia poses to the fetus and mother. If the patient has to be given general anesthesia, one must be aware of and attentive to the changes in blood pressure. Difficulties of intubation because of edema in the larynx may also occur. Currently, the safety of regional anesthesia teeliniques is well established and they can provide good obstelrieal outcome when chosen properly. Epidural anesthesia k widely accepted as the preferred technique of anesthesia for cesarean section in severe pre-edamptic pregnancies. It has been shown to minimize the effect of surgery on caidiopulmonary reserve. Low dose combined spinal epidural anesthesia offering the flexibility of augmenting the block if needed and allows good surgical conditions within 5 min.The purpose of this study was to compare between L-pidural anesthesia, versus low dose combined spinal epidural anesthesia for cesarean section in severe pre-ectarnptic women.This study was carried out on 46 female patients aged beiwecn 20-40 years. Patients were scheduled for cesarean section under either epidural or low dose combined spinal epidural anesthesia
Patients were randomly assigned into two- equal groups, twenty-three patients each.Group I: Epidural anesthesia was performed using a total volume of 15-25 ml of local anesthetic, injected slowly in 5 ml incremenls with bupivacaine 0.5%.Group II: Low dose combined spinal-epidural anesthesia was performed using 25
microgram fentanyl and 7.5 mg hyperbaric bupivacaine in 2 mi distilled water, 0.1 ml of this mixture per 1 U cm patients height was given intraJhccally with a goal of obtaining a T4 sensory block. The epidural was inserted at a higher space before giving the spinal anesthesia. Aehvation of the epidural was done
if the needed level of the sensory block was not obtained using bupivacine half concentration. All patients were premedicaEed with 1-2 mg midazolame intravenously and 4 g magnesium sullate was given initially, followed by lg/hr for seizure prophylaxis.
The following data were recorded for all patients in both groups:
■ Demographic data.
» Onset of regional block.
■ Hemodynamic parameters including:
Heart rate (beats/rain), systolic, diastolic, mean arterial blood pressure (iiimtfg) and oxygen saturation were recorded at the following times: base line value, immediately after the block, with skin incision, eveiy 15 min during operation and every 1 hr postoperatively lor 2 hr then every 2h for 4 hr .