Clinical Study 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 g fentanyl in total 1.9 mL. The prilocaine-fentanyl group (Group P) received 30 mg, 0.5% hyperbaric prilocaine + 20 g 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, = 0.017, and Group P 13.2 ± 7.5 min versus Group B 15.3 ± 6.6 min, = 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, = 0.024, and 133.8 ± 41.4 min versus 200.4 ± 64.8 min, < 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 ( < 0.001)). Conclusion. 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

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)). Conclusion. 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

High-Risk Left Main Coronary Artery Bypass Surgery Supported by the Impella (R) Recover LP 2.5 Assist Device: An Alternative Insertion Technique

Patients with high-risk coronary lesions such as left main stenosis and a severely depressed left ventricular ejection fraction are at risk of death and morbidity-related complications during coronary artery bypass surgery. Several alternative methods have been developed for managing this problem, but it is still challenging, even for highly experienced and well-equipped cardiac surgery centers. We report the case of a successful coronary artery bypass surgery supported by the Impella(R) Recover LP 2.5 assist device and using an alternative insertion technique for the ascending aorta in a patient with high-risk coronary lesions, such as left main disease

Serum lactate level has prognostic significance after pediatric cardiac surgery

Objective: The determination of postoperative course after cardiac surgery has always been a challenging issue. It is more sophisticated in the pediatric age group. The aim of this investigation was to identify whether increased concentrations of lactate in arterial blood has a predictive value for postoperative morbidity and mortality after heart surgery

The benefits of continuous ultrafiltration in pediatric cardiac surgery

Background-Systemic inflammatory response and capillary leak syndrome, caused by extracorporeal circulation, have negative effects on the function of vital organs during the postoperative period. Modified ultrafiltration (MUF) has been developed as an alternative method to reduce the detrimental effects of cardiopulmonary bypass. The aim of this prospective, randomized study is to analyze the effects of MUF in a pediatric population undergoing congenital cardiac surgery