This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vaghadia, H. Articles by Berrill, A. Search for Related Content PubMed PubMed Citation Articles by Vaghadia, H. Articles by Berrill, A.

Selective spinal anesthesia for outpatient laparoscopy. I: Characteristics of three hypobaric solutions

Himat Vaghadia, MB BS MHSC FCA FRCPC^*,, Daniel Viskari, MD FRCPC^*, G.W.E. Mitchell, MB CHB FRCOG FRCS(Ed) FRCSC and Andrew Berrill, MB FCA^*

^* From the Departments of Anesthesia,
Health Care and Epidemiology, and
Gynaecology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.

Address correspondence to: Dr. Himat Vaghadia, The Department of Anesthesia, Vancouver General Hospital, 3200 - 910 West 10th Ave, Vancouver, BC, V5Z 4E3 Canada. Phone: 604-875-4304; Fax: 604-875-5209; E-mail: hvaghadi{at}vanhosp.bc.ca

Purpose: To determine the characteristics and recovery profiles of three hypobaric spinal anesthetic solutions.

Methods: Thirty outpatients undergoing outpatient laparoscopy were randomly assigned to receive spinal anesthesia with one of three small-dose solutions. Group I - 20 mg lidocaine plus 25 µg fentanyl; Group II - 20 mg lidocaine plus 10 µg sufentanil; Group III - 10 mg lidocaine plus 10 µg sufentanil. Solutions were diluted to three ml with sterile water for injection. A 27-gauge Whitacre needle was inserted at L_2-3 or L_3-4 in the sitting position. Sensory and motor recovery were assessed with pinprick, proprioception, light touch and a modified Bromage scale.

Results: Operating conditions were good to excellent in all three groups. The incidence of shoulder tip discomfort, pruritus and nausea was not significantly different between groups. Light touch was present in all three groups and proprioception was present in most patients during and after surgery. Group III patients had a more rapid recovery of pinprick analgesia and Group II patients had the slowest recovery of pinprick analgesia. Motor block recovery was comparable in the three groups. Eighty percent of patients in Groups III and I were able to perform‘deep knee bends’ and ‘straight leg raises’ at the end of surgery.

Conclusion: For short duration laparoscopy, spinal 10 mg lidocaine with 10 µg sufentanil provided selective pin prick analgesia, with preserved touch, proprioception and limited motor block. Operating conditions were satisfactory and most patients were able to fulfill ‘walk out’ criteria at the end of surgery.

This article has been cited by other articles:

				B. Ben-David, P. J. DeMeo, C. Lucyk, and D. Solosko Minidose Lidocaine-Fentanyl Spinal Anesthesia in Ambulatory Surgery: Prophylactic Nalbuphine Versus Nalbuphine Plus Droperidol Anesth. Analg., December 1, 2002; 95(6): 1596 - 1600. [Abstract] [Full Text] [PDF]

				P. H. Lennox, H. Vaghadia, C. Henderson, L. Martin, and G. W. E. Mitchell Small-Dose Selective Spinal Anesthesia for Short-Duration Outpatient Laparoscopy: Recovery Characteristics Compared with Desflurane Anesthesia Anesth. Analg., February 1, 2002; 94(2): 346 - 350. [Abstract] [Full Text] [PDF]

				S. Ganapathy Walking spinals: a myth or reality?/La rachianesthesie ambulatoire : un mythe ou une realite? Can J Anesth, March 1, 2001; 48(3): 222 - 224. [Full Text] [PDF]

				H. Vaghadia, M. A. Solylo, C. L. Henderson, and G.W.E. Mitchell Selective spinal anesthesia for outpatient laparoscopy. II: Epinephrine and spinal cord function Can J Anesth, March 1, 2001; 48(3): 261 - 266. [Abstract] [Full Text] [PDF]

				C. L. Henderson, J. Schmid, H. Vaghadia, C. Fowler, and G.W.E. Mitchell Selective spinal anesthesia for outpatient laparoscopy. III: Sufentanil vs lidocaine-sufentanil Can J Anesth, March 1, 2001; 48(3): 267 - 272. [Abstract] [Full Text] [PDF]

				C. R. Chilvers, A. Goodwin, H. Vaghadia, and G.W.E. Mitchell Selective spinal anesthesia for outpatient laparoscopy. V: Pharmacoeconomic comparison vs general anesthesia Can J Anesth, March 1, 2001; 48(3): 279 - 283. [Abstract] [Full Text] [PDF]