Necessity of combined spinal epidural technique duringopen abdominal myomectomy for huge uterine fibroids

Abstract

Background: Open abdominal myomectomy is commonly done to remove uterine fibroids which plague several Africans and people of African origin especially at the prime of their reproductive careers. Various anaesthetic techniques have been described for this surgical procedure. Some of the techniques have disadvantages.

Objective: The aim of this study was to demonstrate the necessity and safety of the combined spinal epidural technique during open abdominal myomectomy for huge uterine fibroids. Methodology. A 5 years prospective study of 100 women with huge uterine fibroids, who had open abdominal myomectomy with combined spinal
epidural (CSE) technique at Nimley Medical Consultants hospital, Kelsey Harrison hospital and the University of Port-Harcourtteaching hospital, was done. Data collected were analyzed with statistical package for social sciences (SPSS) version 17.0.P value < 0.05 was regarded as statistically significant.

Results. The mean age of the women was 32.53 ± 0.66 years. The mean fibroid size was 30.15 ± 0.68 weeks and the mean surgical duration was 178 .98 ±  3.31 minutes. The epidural component of the CSE was activated after a mean time of 106.15 ± 3.22minutes from the initiation of spinal anaesthesia at a mean numeric pain rating score (NRS) of > 3cm. The rate of perioperative complications was low.

Conclusion. Combined spinal epidural technique is a safe and necessary technique with relatively low rate of perioperative complications when used during open abdominal myomectomy for commonly found huge African fibroids.