A randomized clinical trial comparing the effect of different techniques of selective spinal anaesthesia in cystoscopic procedures

Abstract EN

Background : selective spinal anaesthesia is commonly used in cystoscopic procedures.

Addition of different analgesic drugs to spinal bupivacaine anaesthesia could potentiate its analgesic effects.

Aim of the study : this work was designed to compare the effect of small dose of neostigmine (50 µg) or fentanyl (25 µg) when used as an adjuvant to spinal bupivacaine anaesthesia.

Patients and Methods : the study included 45 patients, ASA I or II scheduled for cystoscopic procedures at NCI.

The patients were randomly allocated into 3 groups, 15 patients each, according to the test solution added to spinal bupivacaine anaesthesia : Group I, (control group) where patients received 1 ml of IT saline, while patients in group II (neostigmine group) received 50 µg.

IT neostigmine.

In group III, patients received 25 µg.

IT fentanyl as an analgesic adjuvant to bupivacaine anaesthesia.

Results : neostigmine 50 µg added to spinal bupiva-caine anaesthesia significantly increased the duration of sensory and motor block.

It also increased the time until discharge.

Sedation and nausea were the most common side effects.

Fentanyl 25 µg added to the same spinal anaesthesia, did not affect motor block, and while potentiating the sensory block criteria.

Conclusion : selective spinal anaesthesia (SSA) is appropriate and safe for use in outpatient procedures.

Neo-stigmine or fentanyl added to IT bupivacaine may improve the quality of spinal anaesthesia with low incidence of adverse effects.