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