title: [Low-dose hypobaric spinal anesthesia for anorectal surgery in jackknife position: levobupivacaine-fentanyl compared to lidocaine-fentanyl].
abstract: OBJECTIVE
  To compare the percentage of patients who were able to bypass the postoperative intensive care recovery unit after selective spinal anesthesia with lidocaine-fentanyl versus levobupivacaine-fentanyl for anorectal surgery in jackknife position.
  
  
  METHODS
  Randomized double-blind clinical trial comparing 2 groups of 30 patients classified ASA 1-2. One group received 18 mg of 0.6% lidocaine plus 10 microg of fentanyl while the other group received 3 mg of 0.1% levobupivacaine plus 10 microg of fentanyl. Intraoperative variables were time of start of surgery, maximum extension of sensory blockade, requirement for rescue analgesics, and hemodynamic events. The level of sensory blockade was recorded at 5, 10, and 15 minutes after the start of surgery and at the end of the procedure. The degrees of postoperative motor blockade and proprioception were recorded, as were the results of the Romberg test and whether or not the patient was able to bypass the postoperative recovery unit. Also noted were times of start of ambulation and discharge, complications, and postoperative satisfaction.
  
  
  RESULTS
  Intraoperative variables did not differ significantly between groups, and all patients in both groups bypassed the postoperative recovery unit. Times until walking and discharge home, complications, and overall satisfaction after surgery were similar in the 2 groups.
  
  
  CONCLUSIONS
  Both spinal anesthetic solutions provide effective, selective anesthesia and are associated with similar rates of recovery care unit bypass after anorectal surgery in jackknife position.
authors.affiliation: Departamento de Anestesiología, Hospital USP La Colina, S.C. de Tenerife, Tenerife. jdesantiagom@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: de Santiago
authors.forename: J
authors.initials: J
authors.lastname: Santos-Yglesias
authors.forename: J
authors.initials: J
authors.lastname: Girón
authors.forename: A
authors.initials: A
authors.lastname: Jiménez
authors.forename: C L
authors.initials: CL
authors.lastname: Errando
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D001003:Anal Canal / Q000601:surgery; D000762:Anesthesia Recovery Period; D000775:Anesthesia, Spinal / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D013505:Digestive System Surgical Procedures; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D000077554:Levobupivacaine; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011187:Posture; D011446:Prospective Studies; D011997:Recovery Room / Q000706:statistics & numerical data; D012007:Rectum / Q000601:surgery
chemical_list: D000759:Adjuvants, Anesthesia; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008012:Lidocaine; D000077554:Levobupivacaine; D005283:Fentanyl; D002045:Bupivacaine