Spinal anaesthesia with hyperbaric prilocaine in day-case perianal surgery: randomised controlled trial.
BACKGROUND
The local anaesthetics used in day-case spinal anaesthesia should provide short recovery times. We aimed to compare hyperbaric prilocaine and bupivacaine in terms of sensory block resolution and time to home readiness in day-case spinal anaesthesia. MeTHODS: Fifty patients undergoing perianal surgery were randomized into two groups. The bupivacaine-fentanyl group (Group B) received 7.5 mg, 0.5% hyperbaric bupivacaine + 20 μg fentanyl in total 1.9 mL. The prilocaine-fentanyl group (Group P) received 30 mg, 0.5% hyperbaric prilocaine + 20 μg fentanyl in the same volume.


RESULTS
Time to L1 block and maximum block was shorter in Group P than in Group B (Group P 4.6 ± 1.3 min versus Group B 5.9 ± 01.9 min, P = 0.017, and Group P 13.2 ± 7.5 min versus Group B 15.3 ± 6.6 min, P = 0.04). The time to L1 regression and S3 regression of the sensorial block was significantly shorter in Group P than in Group B (45.7 ± 21.9 min versus 59.7 ± 20.9 min, P = 0.024, and 133.8 ± 41.4 min versus 200.4 ± 64.8 min, P < 0.001). The mean time to home readiness was shorter for Group P than for Group B (155 ± 100.2 min versus 207.2 ± 62.7 min (P < 0.001)).


CONCLUSIONS
Day-case spinal anaesthesia with hyperbaric prilocaine + fentanyl is superior to hyperbaric bupivacaine in terms of earlier sensory block resolution and home readiness and the surgical conditions are comparable for perianal surgery.
Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Caddesi 112 Altındağ, Akasya Sokak 9/10 Koru Mah. Cayyolu, 06810 Ankara, Turkey.
Ozden Gorgoz
OG
Kaban
Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Caddesi 112 Altındağ, Akasya Sokak 9/10 Koru Mah. Cayyolu, 06810 Ankara, Turkey.
Dilek
D
Yazicioglu
Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Caddesi 112 Altındağ, Akasya Sokak 9/10 Koru Mah. Cayyolu, 06810 Ankara, Turkey.
Taylan
T
Akkaya
Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Caddesi 112 Altındağ, Akasya Sokak 9/10 Koru Mah. Cayyolu, 06810 Ankara, Turkey.
M Murat
MM
Sayin
Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Caddesi 112 Altındağ, Akasya Sokak 9/10 Koru Mah. Cayyolu, 06810 Ankara, Turkey.
Duray
D
Seker
Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Caddesi 112 Altındağ, Akasya Sokak 9/10 Koru Mah. Cayyolu, 06810 Ankara, Turkey.
Haluk
H
Gumus
D000328:Adult; D000556:Ambulatory Surgical Procedures; D001003:Anal Canal / Q000601:surgery*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local; D002045:Bupivacaine; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D011318:Prilocaine
D000779:Anesthetics, Local; D004338:Drug Combinations; D011318:Prilocaine; D005283:Fentanyl; D002045:Bupivacaine