Comparative study between continuous epidural anaesthesia and continuous Wiley Spinal® anaesthesia in elderly patients undergoing TURP

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

Figure 1 The Wiley Spinal® Kit (Epimed; Johnstown, NY) [13].

Figure 2 Insertion of Wiley Spinal™ Kit (Epimed; Johnstown, NY) [13]. a. An 18-gauge Tuohy peel-away epidural sheath was introduced. b. A 27-gauge spinal needle was introduced through the epidural sheath. c. A 23-gauge flexible cannula was threaded over the spinal needle. d. Peel-away epidural sheath was removed and cannula was advanced over the spinal needle. e. Wik-Wire™ was attached to the Wiley cannula using a luer-lock connection. f. The proximal cap was removed and then the kit was fixed.

Table 1 Demographic data and operative time.

	WSA group (n = 15)	CEA group (n = 15)	P-value
Age (yrs)	65.7 ± 4.9	66.7 ± 5.7	0.713
Weight (Kg)	83.3 ± 9.4	80.3 ± 8.3	0.389
Height (cm)	163.3 ± 6.5	165.2 ± 7.3	0.412
BMI (Kg/m^2)	31.5 ± 5.1	29.7 ± 4.9	0.305
ASA class (II/III)	6/9 (40%/60%)	6/9 (40%/60%)	1.000
Operation Time (min)	87.3 ± 25.3	98.0 ± 23.9	0.187

Data are expressed as mean ± standard deviation or number (%). WSA: Wiley Spinal Anaesthesia. CEA: Continuous Epidural Anaesthesia. P > 0.05 = not significant.

Table 2 Characteristics of neuraxial Anaesthesia.

	WSA group (n = 15)	CEA group (n = 15)	P-value
Onset to T10 (min)	2 (1–8)	5 (3–20)	0.001^b
Time to maximum sensory block (min)	5 (1–20)	7 (3–25)	0.019^a
Time to maximum motor block (min)	9 (2–25)	12 (5–40)	0.033^a
Time to 2 segment sensory regression (min)	40 (16–75)	80 (30–90)	0.003^b
Time to full recovery of motor power (min)	100.0 ± 27.4	130.7 ± 19.5	0.001^b
Time to full recovery of sensation (min)	161.7 ± 28.3	253.3 ± 52.7	0.001^b

Data are expressed as median (minimum-maximum) or mean ± standard deviation. WSA: Wiley Spinal Anaesthesia. CEA: Continuous Epidural Anaesthesia. P > 0.05 = not significant.

a P < 0.05 = significant.

b P < 0.01 = highly significant.

Figure 3 Mean value of MAP (mmHg). WSA: Wiley Spinal Anaesthesia. CEA: Continuous Epidural Anaesthesia. ^*P < 0.05 relative to baseline within the same group. ^#P < 0.05 relative to WSA group.

Figure 4 Mean value of HR (beat/min). WSA: Wiley Spinal Anaesthesia. CEA: Continuous Epidural Anaesthesia. ^*P < 0.05 relative to baseline within the same group. ^†P < 0.05 relative to WSA group.

Table 3 Postoperative complications.

	WSA group (n = 15)	CEA group (n = 15)	P-value
Nausea	0 (0%)	1 (6.7%)	0.309
Vomiting	1 (6.7%)	0 (0%)	0.309
Pruritus	1 (6.7%)	1 (6.7%)	1.000
Headache	1 (6.7%)	0 (0%)	0.309
Hypotension	4 (26.7%)	3 (20%)	0.666
Bradycardia	3 (20%)	1 (6.7%)	0.283
Paraesthesia	0 (0%)	2 (13.3%)	0.143
Back pain	1 (6.7%)	1 (6.7%)	1.000
Numbness	1 (6.7%)	0 (0%)	0.309
Lower limb weakness	0 (0%)	0 (0%)	1.000

Data are expressed as number (%). WSA: Wiley Spinal Anaesthesia. CEA: Continuous Epidural Anaesthesia. P > 0.05 = not significant.