Practicability and patients' subjective experiences of low-dose spinal anaesthesia using hyperbaric bupivacaine for transanal surgery.
OBJECTIVE
The safety, effectiveness and long lasting post-operative analgesia make spinal anaesthesia in saddle block technique an "ideal" method for transanal surgery. To improve patient satisfaction and offer reliable operation conditions to surgeons, this study quantifies practicability and patients' subjective experiences with this technique.


METHODS
Within a 5-month period, 400 consecutive patients undergoing transanal surgery in saddle block technique were evaluated by a standardised questionnaire.


RESULTS
The success rate of spinal anaesthesia was 99.5%. Side effects occurred far less frequently as mentioned in the literature. The duration of the sensory block was about twice as long as the time until first mobilisation and micturition. Despite some negative experiences during the procedure, 92% of the investigated patients would choose a saddle block again.


CONCLUSIONS
Both from reasons of practicability and from patients' view, spinal anaesthesia in saddle block technique can be thoroughly recommended for transanal surgery. Patients undergoing a stapler haemorrhoidectomy should receive additional opioids.
Schmittner
Marc D
MD
Clinic of Anaesthesiology and Critical Care Medicine, University Hospital Mannheim, Mannheim, Germany. marc.schmittner@anaes.ma.uni-heidelberg.de
Janke
Andrea
A
Weiss
Christel
C
Beck
Grietje C
GC
Bussen
Dieter G
DG
D001003:Anal Canal / Q000601:surgery*; D000775:Anesthesia, Spinal; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use*; D003625:Data Collection; D003710:Demography; D004305:Dose-Response Relationship, Drug; D005260:Female; D005402:Fistula / Q000601:surgery; D006484:Hemorrhoids / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011300:Preoperative Care; D011795:Surveys and Questionnaires; D013997:Time Factors
D002045:Bupivacaine