COMPARISON OF SPINAL AND EPIDURAL-ANESTHESIA FOR PATIENTS YOUNGER THAN 50 YEARS OF AGE

To evaluate the respective clinical value of spinal anesthesia with 24 -gauge Sprotte needles and epidural anesthesia for younger subjects, 2 02 patients younger than 50 yr were assigned randomly to undergo one o f these two techniques for orthopedic, vascular, urologic, or plastic surgery. Failed blocks occurred in 5% in each group. Spinal anesthesia resulted in significantly less time to achieve sufficient spread of b lock; a significantly lower incidence of incomplete sensory block at l evel L5/S1, incomplete motor block, and pain during surgery; and a sig nificantly lower incidence of postlumbar puncture backache (11% vs 30% after epidural anesthesia). The incidence of postdural puncture heada che (PDPH) in the spinal and epidural groups was 7% and 4%, respective ly (P = not significant), and patient satisfaction was 97% and 93% (P = not significant). Our results demonstrate the effectiveness of both techniques in younger patients, but show that the spinal technique is associated with fewer limitations, suggesting that factors other than PDPH should be considered when choosing between these two techniques.