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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2014 June;80(6):685-91
Comparison of unilateral and bilateral spinal anesthesia with 2% hyperbaric prilocaine in day-case inguinal herniorrhaphy: a randomized controlled trial
Manassero A., Bossolasco M., Ugues S., Bailo C., Liarou C., Coletta G. ✉
S. Croce e Carle Hospital, Cuneo, Italy
BACKGROUND: Hyperbaric 2% prilocaine produces a faster onset and shorter duration of spinal anesthesia than a plain solution. The anesthetic profile could be improved by restricting the block to the operative side. We compared unilateral versus conventional bilateral spinal anesthesia with hyperbaric 2% prilocaine in day-case patients undergoing unilateral inguinal herniorrhaphy.
METHODS: Eighty patients were randomly assigned to receive either conventional bilateral (N.=40) or unilateral (N.=40) spinal anesthesia with 50 mg hyperbaric prilocaine 2%. In the unilateral group, lateral decubitus was maintained for 10 minutes. Sensory and motor block courses, time to first micturition, and side effects were recorded.
RESULTS: On the operated side, the highest sensory block was T8 (T12-T2) in the unilateral and T9 (T11-T4) in the bilateral group (P=0.0328); the time to motor (115±26 min in the unilateral and 108±24 min in the bilateral groups, P=0.2350) and sensory (156±30 min in the unilateral and 158±26 min in the bilateral groups, P=0.7550) block resolution was similar in both groups. On the non-operated side, the unilateral group had a faster motor (64±48, P<0.001) and sensory (120±47, P<0.001) time to block resolution than the conventional group. Restricted unilateral motor and sensory block was achieved in 30% and 12.5% of patients, respectively. Time to voiding was shorter in the unilateral than in the conventional group (220±47 vs. 249±51 min, respectively, P=0.0104). There were no significant differences in adequacy for surgery and side effects between the groups.
CONCLUSION: In day-case inguinal herniorrhaphy, attempting unilateral spinal anesthesia with 50 mg hyperbaric 2% prilocaine produced faster time to voiding.