title: Spinal versus epidural anesthesia for vesicovaginal fistula repair surgery in a rural sub-Saharan African setting.
abstract: OBJECTIVE
  To compare spinal anesthesia with epidural anesthesia in patients undergoing surgery for vesicovaginal fistula (VVF) repair.
  
  
  METHODS
  Nonrandomized, prospective, clinical, pilot study.
  
  
  METHODS
  Rural African hospital with 165 beds.
  
  
  METHODS
  60 ASA physical status I and II patients undergoing VVF repair surgery.
  
  
  METHODS
  30 patients were included in each study group. Spinal (1.5-2 mL hyperbaric bupivacaine 0.75%) or lumbar epidural (20-24 mL bupivacaine 0.5%) anesthesia was administered to the patients.
  
  
  METHODS
  Demographics, quality of anesthesia, duration of postoperative analgesia, as well as preoperative, intraoperative, and postoperative data, were all recorded. Data were compared between study groups using unpaired Student's t test for continuous variables and chi(2) and Fisher's exact tests for categorical data.
  
  
  RESULTS
  Quality of anesthesia was different between groups (P = 0.009). Good anesthesia quality was significantly more frequent in the spinal (86.7%) than the epidural group (50%, P = 0.005). Postoperative analgesia quality was comparable (P = 0.347). There were no differences between groups in hemodynamic parameters before, during, or after surgery.
  
  
  CONCLUSIONS
  Spinal anesthesia proved to be the better anesthetic technique for VVF repair surgery when compared with epidural anesthesia in a rural, sub-Saharan African setting.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, DOCS Hospital, Goma, Democratic Republic of the Congo.
authors.forename: Baelani
authors.initials: B
authors.lastname: Inipavudu
authors.forename: Gottfried
authors.initials: G
authors.lastname: Mitterschiffthaler
authors.forename: Walter R
authors.initials: WR
authors.lastname: Hasibeder
authors.forename: Martin W
authors.initials: MW
authors.lastname: Dünser
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D014719:Vesicovaginal Fistula / Q000601:surgery*