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Selective spinal anesthesia for outpatient laparoscopy. III: Sufentanil vs lidocaine-sufentanil

Cynthia L. Henderson, MD FRCPC^*, Josie Schmid, MD^*, Himat Vaghadia, MB BS MHSC FCA FRCPC^*,, Carolyn Fowler , MBCHB FANZCA^* and G.W.E. Mitchell, MB CHB FRCOG FRCS (ed) FRCSC

^* 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. Cynthia Henderson, Department of Anesthesia, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9. E-mail: chenders{at}vanhosp.bc.ca

Purpose: The efficacy of low dose intrathecal lidocaine-sufentanil was compared with intrathecal sufentanil for short duration outpatient gynecological laparoscopy.

Methods: Thirteen ASA I and II patients undergoing gynecological laparoscopy were studied in a randomized double-blind trial. Patients received either intrathecal 10 mg lidocaine plus 10 µg sufentanil (Group LS) or intrathecal 20 µg sufentanil (Group S), each diluted to 3 mL with sterile water through a 27g Whitacre needle in the sitting position. Sensory and motor recovery were assessed with pinprick and a modified Bromage scale.

Results: One of seven Group LS patients and two of five Group S patients required conversion to general anesthesia for failed skin test with forceps. Two of the remaining three Group S patients felt sharpness with skin incision. The study was terminated early because of inadequate anesthesia in Group S. The small sample size (n=9) made statistical analysis uninformative.

Conclusion: Intrathecal 20 µg sufentanil is unsuitable as a sole agent for gynecological laparoscopy.

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