Intrathecal lidocaine and sufentanil shorten postoperative recovery after outpatient rectal surgery.
OBJECTIVE
A short recovery time for same day surgery is important to the patient and the hospital. A prospective, randomized, double-blinded study in the postanesthetic care unit was designed to compare the recovery time from spinal anesthesia with low-dose intrathecal (IT) lidocaine and sufentanil to that with IT lidocaine alone. The incidence of adverse effects was also assessed.


METHODS
Forty-nine patients (ASA I-III, age 20-69 yr) underwent spinal anesthesia for rectal surgery. The patients were randomized into two groups. One group (n = 28) received low-dose IT lidocaine (15 mg) and sufentanil (10 microg) and the other group (n = 21) received IT lidocaine (50 mg). The time to ambulation, the incidence of pruritus, and other variables were recorded. Statistical difference was assumed if P < 0.05.


RESULTS
Our results show a significantly shorter ambulation time (120 +/- 26 min) after IT low-dose lidocaine (15 mg) and 10 microg sufentanil vs 50 mg IT lidocaine (162 +/- 32 min, P < 0.0001). Patients who received IT lidocaine and sufentanil recovered faster. Fifty percent of the patients who received IT sufentanil suffered from pruritus.


CONCLUSIONS
IT lidocaine (15 mg) and sufentanil resulted in a shorter time to ambulation compared to IT lidocaine (50 mg) alone and provided excellent anesthesia despite its disadvantage of pruritus.
Waxler
Beverly
B
Division of Postanesthesia Care, Department of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA. 74731.463@compuserve.com
Mondragon
Shirley A
SA
Patel
Sonal N
SN
Nedumgottil
Kochuthresia
K
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D000775:Anesthesia, Spinal / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D017409:Sufentanil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008012:Lidocaine; D017409:Sufentanil