الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Neuraxial anesthesia is commonly used in combination with GA to reduce the amount of anesthetic and analgesic drugs. The CEG anesthesia is frequently used in major abdominal surgery. CSG anesthesia offered several advantages as blunting of stress response. CSEG technique is associated with a blunted stress response and relies on minimal doses for maximal benefits.
This study was conducted on 130 adult patients submitted for elective abdominal surgical procedures expected to be > 2 hours. Patients were randomly assigned to receive epidural 20 ml bupivacaine 0.2% plus 30µg fentanyl in combined epidural-general (CEG) group, spinal 3 ml isobaric bupivacaine 0.5% plus 15µg fentanyl in combined spinal-general (CSG) group or epidural 20 ml bupivacaine 0.1% plus 15µg fentanyl epiduraly then spinal 2 ml isobaric bupivacaine 0.5% plus 10µg fentanyl in combined spinal-epidural-general (CSEG) group then GA was started. Hemodynamic variables, adequacy of intraoperative analgesia, anesthetic and analgesic requirements, pain score, laboratory investigations, PEFR and any complications were recorded.
The study reveled that the that preemptive spinal bupivacaine-fentanyl analgesia was not equipotent to pre-emptive epidural bupivacaine-fentanyl analgesia as CEG anesthesia was associated with longer postoperative analgesic duration but, it was unfavorably accompanied with more hypotension. CSEG was associated with longer postoperative analgesia when compared to CSG with minimal side effects.