title: Prilocaine spinal anesthesia for ambulatory surgery: A review of the available studies.
abstract: Transient neurologic symptoms (TNS) led to the abandonment of intrathecal lidocaine. We reviewed the published literature for information about the duration of action and side effects of intrathecal prilocaine, which has been recently reintroduced in Europe. Medline and EMBASE databases were searched for the time period from 1966 to 2015. Fourteen prospective and one retrospective study were retrieved. The duration of the surgical block can be adjusted using doses between 40 and 80mg. Hyperbaric prilocaine in doses as low as 10mg can be used for perianal procedures. Four cases of TNS in 486 patients were reported in prospective studies, and none in 5000 cases in a retrospective data set. Spinal prilocaine appears to be safe and reliable for day case anesthesia. However, as chloroprocaine has a shorter duration and a lower risk of TNS and urinary retention, the indications for prilocaine remain to be defined.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, USA. Electronic address: jan.boublik@gmail.com.
authors.forename: Jan
authors.initials: J
authors.lastname: Boublik
authors.affiliation: Department of Anesthesiology, Stony Brook School of Medicine, Stony Brook, NY, USA. Electronic address: guptar2005@yahoo.com.
authors.forename: Ruchir
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Long Island University School of Pharmacy, Brooklyn, NY, USA. Electronic address: supurna_bhar@yahoo.com.
authors.forename: Supurna
authors.initials: S
authors.lastname: Bhar
authors.affiliation: Department of Anesthesiology, NYU School of Medicine, 301 East 17th Street, Rm C2-222, 10003 New York, NY, USA. Electronic address: arthur.atchabahian@gmail.com.
authors.forename: Arthur
authors.initials: A
authors.lastname: Atchabahian
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000779:Anesthetics, Local; D011318:Prilocaine
keywords: Ambulatory surgery; Intrathecal; Prilocaine; Spinal; Transient neurological syndrome; Urinary retention