title: Spinal anaesthesia in outpatient and conventional surgery: A point of view from experienced French anaesthetists.
abstract: BACKGROUND
  The objective of this investigation was to evaluate the practice of spinal anaesthesia among French anaesthetists in inpatient and outpatient settings.
  
  
  METHODS
  A questionnaire was sent to members of the French Association of Anaesthetists involved in regional anaesthesia during the first 4months of 2015. The questionnaire included items on the practice of spinal anaesthesia (type of needle, local anaesthetic available, puncture and disinfection techniques, etc.) and on the anaesthetic techniques usually used in 5 surgical situations eligible for outpatient surgery (knee arthroscopy, inguinal hernia, transobturator tape, haemorrhoids, varicose veins in the lower limbs).
  
  
  RESULTS
  Responses from 703 anaesthesiologists were analysed. Spinal anaesthesia was usually performed in a sitting position (76%) using a Whitacre needle (60%) with a 25 G (57%) diameter. Ultrasound before puncture was reported in 26% of cases due to obesity or spinal abnormalities. Among the 5 surgical situations eligible for outpatient spinal anaesthesia, the technique was typically proposed in 29-49% of cases. Bupivacaine was the most used local anaesthetic. Concerns over delays in attaining readiness for hospital discharge, urine retention, operation length, and surgeon's preference were the main reasons for choosing another anaesthetic technique in these situations.
  
  
  CONCLUSIONS
  New local anaesthetics are beginning to be used for outpatient spinal anaesthesia due to their interesting pharmacodynamic profile in this context. This study will provide a basis for evaluating future changes in practice.
authors.affiliation: Inserm 1027, department of Anaesthesiology, institut Claudius-Regaud IUCT-O, 31059 Toulouse cedex, France. Electronic address: fuzier.r@gmail.com.
authors.forename: Régis
authors.initials: R
authors.lastname: Fuzier
authors.affiliation: Department of Anaesthesia and Critical Care, polyclinique Sévigné, 3, rue du Chene-Germain, 35510 Cesson-Sévigné, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Aveline
authors.affiliation: Department of Anaesthesiology and Critical Care, CHU Bicêtre, 94275 Kremlin-Bicêtre, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Zetlaoui
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Lapeyronie University Hospital, 371, avenue du Doyen Gaston-Giraud, 34090 Montpellier, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Choquet
authors.affiliation: Department of Anaesthesiology and Critical Care, Nancy University Hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Bouaziz
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000775:Anesthesia, Spinal / Q000295:instrumentation / Q000706:statistics & numerical data*; D000072080:Anesthesiologists; D000779:Anesthetics, Local; D002045:Bupivacaine; D000066491:Clinical Decision-Making; D015331:Cohort Studies; D005602:France; D019538:Health Care Surveys; D006801:Humans; D009339:Needles; D056888:Patient Positioning; D013514:Surgical Procedures, Operative / Q000379:methods*; D011795:Surveys and Questionnaires; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: Local anaesthetics; Outpatient; Spinal anaesthesia