Spinal Anaesthesia with Hyperbaric Prilocaine in Day-Case Perianal Surgery: Randomised Controlled Trial

Abstract EN

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.