Combined Epidural/Spinal Anaesthesia With New Needle-Beside-Needle Technique For Caesarean Section: A Randomized Controlled Trial

Objective: The aim of this study was to compare safety and availability between a new needle-beside-needle (NBN) technique and the traditional needle-through-needle (NTN) technique for combined epidural/spinal anesthesia during cesarean section. This was a prospective randomized controlled trial. Methods: Parturients scheduled for elective cesarean section were randomized to receive NBN (n = 58) or NTN technique (n = 57) for combined epidural/spinal anesthesia (CSEA). An observer, blinded to the study, recorded drug dosages, hemodynamic indexes, procedure times, duration from spinal injection to returning patients to supine position, epidural and spinal puncture counts, maximum sensory levels, adverse events, and evaluation of the anesthetist and patients regarding the two techniques. Results: Procedure time (P = 0.049) and duration from spinal injection to returning patients to supine position (P < 0.001) in NBN group were less than the NTN group. Satisfaction of patients regarding the two techniques were comparable, while anesthetist satisfaction was higher in the NBN group (P = 0.006). In addition, the spinal needle was more stable in the NBN group compared with NTN group (P < 0.001). There were no statistically significant adverse events and requirement of anesthetics between the two groups. No differences were found in maximum sensory levels, count of intra-spinal punctures, and failures on first attempt. Conclusion: The higher stability of spinal needle highlighted the superior performance of NBN technique, compared to the traditional NTN technique, during cesarean section. With less procedure time and less interval from spinal injection to returning patients to supine position, this new NBN technique may be welcomed as the current admirable equipment.