Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study

Sotonye Fyneface-Ogan; Otokwala Job Gogo

doi:doi:10.11648/j.ja.20130103.14

| Peer-Reviewed

Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study

Sotonye Fyneface-Ogan, Otokwala Job Gogo

Published in Journal of Anesthesiology (Volume 1, Issue 3)

Received: 4 January 2014 Accepted: Published: 30 January 2014

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Continuous spinal anaesthesia during Caesarean delivery has been found to offer considerable advantages over "single-shot" spinal. Aim: This study aimed to find the difference between priming and non-priming of the Wik-Wire extension set with local anaesthetic on the induction-incision interval. Methods: Thirty ASA I and II parturients aged between 21 and 38 years scheduled for elective repeat Caesarean section were randomly allocated into one of two groups of 15 patients each. Patients in Group A had the Wik-Wire extension set primed with 1 ml of isobaric bupivacaine and threaded through flexible cannula. On connection with the hub of the cannula, back flow of cerebrospinal fluid (CSF) was confirmed by a drop hanging at the hub of the set. Group 2 patients had the un-primed Wik-Wire extension set connected to the flexible cannula. On connection with the hub of the cannula, back flow of CSF was evidenced by lowering the extension set to fill the tubing until the proximal cap of extension set was fully primed with passive flow of CSF. Isobaric 0.5% bupivacaine 10 mg was then administered intrathecally as the parturients returned supine while ensuring 15o left uterine displacement. Induction to delivery interval (I-D), defined as time from institution of induction of regional anaesthesia to delivery was studied. Results: All patients had satisfactory anaesthesia. The mean induction to incision (I-I) interval in group A 3.8 ± 1.5 mins while this was 7.2 ± 2.2 mins in group B, p=0.001. One patient in group B required a single dose of 5 mg ephedrine; while none required vasopressor support in group B. Conclusions: The study concludes that a primed Wik-Wire extension set can significantly reduce the induction of continuous spinal anaesthesia to delivery interval provides a fast and effective anaesthesia for caesarean section.

Published in	Journal of Anesthesiology (Volume 1, Issue 3)
DOI	10.11648/j.ja.20130103.14
Page(s)	36-40
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Repeat Caesarean Section, Continuous Spinal Anaesthesia, Isobaric Bupivacaine

References

[1]	Bevacqua BK. Continuous spinal anaesthesia: what's new and what's not. Best Pract Res Clin Anaesthesiol 2003; 17: 393-406.
[2]	Hinebaugh MC, Lang WR. Continuous spinal anesthesia for labor and delivery. A preliminary report. Ann Surgery 1944; 120: 129–142.
[3]	Arkoosh VA, Palmer CM, Yun EM et al. A randomized, double-masked, multicenter comparison of the safety of continuous intrathecal labor analgesia using a 28-gauge catheter versus continuous epidural labor analgesia. Anesthesiology 2008; 108: 286–298
[4]	Alonso E, Gilsanz F, Gredilla E, Martınez B, Canser E, Alsina E. Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery. Int J Obstet Anesth 2009; 18: 137-141
[5]	Turker G, Gurbet A, Aksu HA. Continuous spinal analgesia in parturients with severe heart disease. Int J Obstet Anesth 2007; 16: 298–299
[6]	Velickovic IA, Leicht CH. Continuous spinal anesthesia for cesarean section in a parturient with severe recurrent peripartum cardiomyopathy. Int J Obstet Anesth 2004; 13: 40–43.
[7]	Goyal M, Taxak S, Kshetrapal KK, Goel MK. Continuous spinal anesthesia in a high risk elderly patient using epidural set. J Anaesth Clin Pharm 2011; 27: 139-141
[8]	Tuffnell DJ, Wilkinson K, Beresford N. Interval between decision and delivery by caesarean section – are current standards achievable? BMJ 2001; 322:1330–1333.
[9]	Confidential Enquiry into Still births and Deaths in Infancy: 7th Annual Report. London: Maternal and Child Health Research Consortium, 2000
[10]	Mokri B. Spontaneous low pressure, low CSF volume headaches: spontaneous CSF leaks. Headache 2013; 53: 1034-1053.
[11]	Rando TA, Fishman RA. Spontaneous intracranial hypotension: report of two cases and review of the literature. Neurology1992; 42: 481–487
[12]	Cruickshank RH, Hopkinson JM. Fluid flow through dural puncture sites. An in vitro comparison of needle point types. Anaesthesia1989; 44: 415–418
[13]	Ready LB, Cuplin S, Haschke RH, Nessly M. Spinal needle determinants of rate of transdural fluid leak. Anesth Analg 1989; 69: 457–460
[14]	Baer ET. Post-dural puncture bacterial meningitis. Anesthesiology 2006; 105: 381.
[15]	Thurlow J, Kinsella SM. Intra-uterine resuscitation: active management of fetal distress. Int J Obstet Anesth 2002; 11: 105–116
[16]	Rees SGO, Thurlow JA, Gardner IC, Scrutton MJL, Kinsella SM. Maternal cardiovascular consequences of positioning after spinal anaesthesia for caesarean section: left 15o table tilt vs. left lateral. Anaesthesia 2002; 57: 15–20
[17]	Mendonca C, Griffiths J, Ateleanu B, Collis RE. Hypotension following combined spinal-epidural anaesthesia for caesarean section: left lateral position vs. tilted supine position. Anaesthesia 2003; 58: 428–431
[18]	Obasuyi BI, Fyneface-Ogan S, Mato CN. A comparison of the haemodynamic effects of lateral and sitting positions during induction of spinal anaesthesia for caesarean section. Int J Obstet Anesth 2013; 22: 124-128.
[19]	Schnider TW, Mueller-Duysing S, Johr M, Gerber H. Incremental dosing versus single dose spinal anesthesia and hemodynamic stability. Anesth Analg 1993; 77: 1174-1178.

Cite This Article

Plain Text BibTeX RIS

APA Style

Sotonye Fyneface-Ogan, Otokwala Job Gogo. (2014). Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study. International Journal of Anesthesia and Clinical Medicine, 1(3), 36-40. https://doi.org/10.11648/j.ja.20130103.14

Copy | Download

ACS Style

Sotonye Fyneface-Ogan; Otokwala Job Gogo. Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study. Int. J. Anesth. Clin. Med. 2014, 1(3), 36-40. doi: 10.11648/j.ja.20130103.14

Copy | Download

AMA Style

Sotonye Fyneface-Ogan, Otokwala Job Gogo. Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study. Int J Anesth Clin Med. 2014;1(3):36-40. doi: 10.11648/j.ja.20130103.14

Copy | Download

@article{10.11648/j.ja.20130103.14,
  author = {Sotonye Fyneface-Ogan and Otokwala Job Gogo},
  title = {Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {1},
  number = {3},
  pages = {36-40},
  doi = {10.11648/j.ja.20130103.14},
  url = {https://doi.org/10.11648/j.ja.20130103.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20130103.14},
  abstract = {Background: Continuous spinal anaesthesia during Caesarean delivery has been found to offer considerable advantages over "single-shot" spinal. Aim: This study aimed to find the difference between priming and non-priming of the Wik-Wire extension set with local anaesthetic on the induction-incision interval. Methods: Thirty ASA I and II parturients aged between 21 and 38 years scheduled for elective repeat Caesarean section were randomly allocated into one of two groups of 15 patients each. Patients in Group A had the Wik-Wire extension set primed with 1 ml of isobaric bupivacaine and threaded through flexible cannula. On connection with the hub of the cannula, back flow of cerebrospinal fluid (CSF) was confirmed by a drop hanging at the hub of the set. Group 2 patients had the un-primed Wik-Wire extension set connected to the flexible cannula. On connection with the hub of the cannula, back flow of CSF was evidenced by lowering the extension set to fill the tubing until the proximal cap of extension set was fully primed with passive flow of CSF. Isobaric 0.5% bupivacaine 10 mg was then administered intrathecally as the parturients returned supine while ensuring 15o left uterine displacement. Induction to delivery interval (I-D), defined as time from institution of induction of regional anaesthesia to delivery was studied. Results: All patients had satisfactory anaesthesia. The mean induction to incision (I-I) interval in group A 3.8 ± 1.5 mins while this was 7.2 ± 2.2 mins in group B, p=0.001. One patient in group B required a single dose of 5 mg ephedrine; while none required vasopressor support in group B. Conclusions: The study concludes that a primed Wik-Wire extension set can significantly reduce the induction of continuous spinal anaesthesia to delivery interval provides a fast and effective anaesthesia for caesarean section.},
 year = {2014}
}

Copy | Download

TY - JOUR
T1 - Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study
AU - Sotonye Fyneface-Ogan
AU - Otokwala Job Gogo
Y1 - 2014/01/30
PY - 2014
N1 - https://doi.org/10.11648/j.ja.20130103.14
DO - 10.11648/j.ja.20130103.14
T2 - International Journal of Anesthesia and Clinical Medicine
JF - International Journal of Anesthesia and Clinical Medicine
JO - International Journal of Anesthesia and Clinical Medicine
SP - 36
EP - 40
PB - Science Publishing Group
SN - 2997-2698
UR - https://doi.org/10.11648/j.ja.20130103.14
AB - Background: Continuous spinal anaesthesia during Caesarean delivery has been found to offer considerable advantages over "single-shot" spinal. Aim: This study aimed to find the difference between priming and non-priming of the Wik-Wire extension set with local anaesthetic on the induction-incision interval. Methods: Thirty ASA I and II parturients aged between 21 and 38 years scheduled for elective repeat Caesarean section were randomly allocated into one of two groups of 15 patients each. Patients in Group A had the Wik-Wire extension set primed with 1 ml of isobaric bupivacaine and threaded through flexible cannula. On connection with the hub of the cannula, back flow of cerebrospinal fluid (CSF) was confirmed by a drop hanging at the hub of the set. Group 2 patients had the un-primed Wik-Wire extension set connected to the flexible cannula. On connection with the hub of the cannula, back flow of CSF was evidenced by lowering the extension set to fill the tubing until the proximal cap of extension set was fully primed with passive flow of CSF. Isobaric 0.5% bupivacaine 10 mg was then administered intrathecally as the parturients returned supine while ensuring 15o left uterine displacement. Induction to delivery interval (I-D), defined as time from institution of induction of regional anaesthesia to delivery was studied. Results: All patients had satisfactory anaesthesia. The mean induction to incision (I-I) interval in group A 3.8 ± 1.5 mins while this was 7.2 ± 2.2 mins in group B, p=0.001. One patient in group B required a single dose of 5 mg ephedrine; while none required vasopressor support in group B. Conclusions: The study concludes that a primed Wik-Wire extension set can significantly reduce the induction of continuous spinal anaesthesia to delivery interval provides a fast and effective anaesthesia for caesarean section.
VL - 1
IS - 3
ER -

Copy | Download

Author Information

Sotonye Fyneface-Ogan

Department of Anaesthesia, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Otokwala Job Gogo

Department of Anaesthesia, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Sotonye Fyneface-Ogan, Otokwala Job Gogo. (2014). Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study. International Journal of Anesthesia and Clinical Medicine, 1(3), 36-40. https://doi.org/10.11648/j.ja.20130103.14

Copy | Download

ACS Style

Sotonye Fyneface-Ogan; Otokwala Job Gogo. Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study. Int. J. Anesth. Clin. Med. 2014, 1(3), 36-40. doi: 10.11648/j.ja.20130103.14

Copy | Download

AMA Style

Sotonye Fyneface-Ogan, Otokwala Job Gogo. Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study. Int J Anesth Clin Med. 2014;1(3):36-40. doi: 10.11648/j.ja.20130103.14

Copy | Download

@article{10.11648/j.ja.20130103.14,
  author = {Sotonye Fyneface-Ogan and Otokwala Job Gogo},
  title = {Prospective Study of Priming Versus Non-Priming of Wik-Wire Extension Set during Continuous Spinal Anaesthesia for Repeat Caesarean Section: A Pilot Study},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {1},
  number = {3},
  pages = {36-40},
  doi = {10.11648/j.ja.20130103.14},
  url = {https://doi.org/10.11648/j.ja.20130103.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20130103.14},
  abstract = {Background: Continuous spinal anaesthesia during Caesarean delivery has been found to offer considerable advantages over "single-shot" spinal. Aim: This study aimed to find the difference between priming and non-priming of the Wik-Wire extension set with local anaesthetic on the induction-incision interval. Methods: Thirty ASA I and II parturients aged between 21 and 38 years scheduled for elective repeat Caesarean section were randomly allocated into one of two groups of 15 patients each. Patients in Group A had the Wik-Wire extension set primed with 1 ml of isobaric bupivacaine and threaded through flexible cannula. On connection with the hub of the cannula, back flow of cerebrospinal fluid (CSF) was confirmed by a drop hanging at the hub of the set. Group 2 patients had the un-primed Wik-Wire extension set connected to the flexible cannula. On connection with the hub of the cannula, back flow of CSF was evidenced by lowering the extension set to fill the tubing until the proximal cap of extension set was fully primed with passive flow of CSF. Isobaric 0.5% bupivacaine 10 mg was then administered intrathecally as the parturients returned supine while ensuring 15o left uterine displacement. Induction to delivery interval (I-D), defined as time from institution of induction of regional anaesthesia to delivery was studied. Results: All patients had satisfactory anaesthesia. The mean induction to incision (I-I) interval in group A 3.8 ± 1.5 mins while this was 7.2 ± 2.2 mins in group B, p=0.001. One patient in group B required a single dose of 5 mg ephedrine; while none required vasopressor support in group B. Conclusions: The study concludes that a primed Wik-Wire extension set can significantly reduce the induction of continuous spinal anaesthesia to delivery interval provides a fast and effective anaesthesia for caesarean section.},
 year = {2014}
}

Copy | Download