Comparison of unilateral and bilateral spinal anesthesia with 2% hyperbaric prilocaine in day-case inguinal herniorrhaphy: a randomized controlled trial.
BACKGROUND
Hyperbaric 2% prilocaine produces a faster onset and shorter duration of spinal anesthesia than a plain solution. The anesthetic profile could be improved by restricting the block to the operative side. We compared unilateral versus conventional bilateral spinal anesthesia with hyperbaric 2% prilocaine in day-case patients undergoing unilateral inguinal herniorrhaphy.


METHODS
Eighty patients were randomly assigned to receive either conventional bilateral (N.=40) or unilateral (N.=40) spinal anesthesia with 50 mg hyperbaric prilocaine 2%. In the unilateral group, lateral decubitus was maintained for 10 minutes. Sensory and motor block courses, time to first micturition, and side effects were recorded.


RESULTS
On the operated side, the highest sensory block was T8 (T12-T2) in the unilateral and T9 (T11-T4) in the bilateral group (P=0.0328); the time to motor (115 ± 26 min in the unilateral and 108 ± 24 min in the bilateral groups, P=0.2350) and sensory (156 ± 30 min in the unilateral and 158 ± 26 min in the bilateral groups, P=0.7550) block resolution was similar in both groups. On the non-operated side, the unilateral group had a faster motor (64 ± 48, P<0.001) and sensory (120 ± 47, P<0.001) time to block resolution than the conventional group. Restricted unilateral motor and sensory block was achieved in 30% and 12.5% of patients, respectively. Time to voiding was shorter in the unilateral than in the conventional group (220 ± 47 vs. 249 ± 51 min, respectively, P=0.0104). There were no significant differences in adequacy for surgery and side effects between the groups.


CONCLUSIONS
In day-case inguinal herniorrhaphy, attempting unilateral spinal anesthesia with 50 mg hyperbaric 2% prilocaine produced faster time to voiding.
S. Croce e Carle Hospital, Cuneo, Italy - manassero.al@ospedale.cuneo.it.
A
A
Manassero
M
M
Bossolasco
S
S
Ugues
C
C
Bailo
C
C
Liarou
G
G
Coletta
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000009:adverse effects; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011318:Prilocaine / Q000009:adverse effects; D011446:Prospective Studies; D055815:Young Adult
D000779:Anesthetics, Local; D011318:Prilocaine