[Comparative study between 5% prilocaine and 2% mepivacaine by the subarachnoid route in transurethral resections].
OBJECTIVE
To compare the duration of spinal block with 5% prilocaine and 2% mepivacaine in short procedures for transurethral resection and to assess possible complications in the immediate postoperative period.


METHODS
Fifty-seven patients scheduled for transurethral resection of the prostate or a vesical tumor. Patients were ASA I-III, over 55 years of age and randomly assigned to two groups to receive 5% prilocaine (1 mg/kg, n = 27) or 2% mepivacaine (0.8 mg/kg, n = 30). We collected data on anesthetic technique, levels of extension of motor and sensory blockades, duration of blockades and complications within the first 24 hours after surgery.


RESULTS
Demographic data, ASA classification and duration of surgery were similar in both groups. We found statistically significant differences (p < 0.05) in duration of sensory blockade (120.92 +/- 36.21 min with prilocaine and 145.83 +/- 35.81 min with mepivacaine) and in motor blockade (106.29 +/- 38.16 min with prilocaine and 133.16 +/- 42.21 min with mepivacaine). Five cases of hypotension and 4 of bradycardia occurred in each group and one patient in the mepivacaine group suffered slight postoperative cephalea.


CONCLUSIONS
Both local anesthetics offer good surgical conditions with hemodynamic stability and few complications. The duration of sensory and motor blockade is shorter with prilocaine than with mepivacaine, making prilocaine more appropriate for short interventions.
Plaja
I
I
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari de Girona Dr. Josep Trueta. anestesia@htrueta.scs.es
Arxer
A
A
Metje
M
M
Santiveri
X
X
Villalonga
A
A
Fernández
M A
MA
López
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001340:Autonomic Nerve Block / Q000009:adverse effects; D001919:Bradycardia / Q000139:chemically induced / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000209:etiology; D007431:Intraoperative Complications / Q000139:chemically induced / Q000209:etiology*; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D017060:Patient Satisfaction; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D016037:Single-Blind Method; D013346:Subarachnoid Space; D016683:Supine Position; D013997:Time Factors; D020728:Transurethral Resection of Prostate
D000779:Anesthetics, Local; D011318:Prilocaine; D008619:Mepivacaine