Nghiên cứu hiệu quả của gây tê tủy sống bằng levobupivacain - fentanyl kết hợp với gây tê ngoài màng cứng trong và sau phẫu thuật cắt tử cung, phần phụ qua đường ngang dưới rốn

To evaluate the efficacy of levobupivacain - fentanyl for combined spinal epidural (CSE) anesthesia during and affter hysterectomy, salpingo - oophorectomy through horizontal incision in the lower abdominal. Methods: 70 patients undergoing abdominal hysterectomy, salpingo - oophorectomy with CSE anesthesia were randomized into 2 groups: Group 1: spinal levobupivacain, Group 2: spinal levobupivacain - fentanyl. Results: the percentage of patients needed extra doses of levobupivacain 0,25% during operation of group 1 higher than that of group 2, total dose of levobupivacain used in 48 hours after surgery was similar between 2 groups, good anagelsic effects were obtained in all cases, the mean onset time of motor block M3 was < 7 minutes. Postoperatively, VAS at rest was < 3 in both groups, all patients achieved motor recovery M0 after 4 hours and sedation level N0. Intraoperative and postoperative haemodynamics was stable and there was no respiratory depression. Conclusions: Combined subarachnoid fentanyl reduces the proportion of extra epidural levobupivacain using, CSE does not cause respiratory depression and helps in stablizing haemodynamics, therefore, is a safe choice for high - risk patients.