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Intrathecal lidocaine and sufentanil shorten postoperative recovery after outpatient rectal surgery

[L’administration intrathécale de lidocaïne et de sufentanil diminue le temps de récupération après une opération du rectum en chirurgie ambulatoire]

From the Department of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, USA.

Address correspondence to: Dr. Beverly Waxler, Division of Postanesthesia Care, Department of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA. Phone: 312-864-2140; Fax: 312-864-9544; E-mail: 74731.463{at}compuserve.com

Purpose: A short recovery time for same day surgery is important to the patient and the hospital. A prospective, randomized, double-blinded study in the postanesthetic care unit was designed to compare the recovery time from spinal anesthesia with low-dose intrathecal (IT) lidocaine and sufentanil to that with IT lidocaine alone. The incidence of adverse effects was also assessed.

Methods: Forty-nine patients (ASA I–III, age 20–69 yr) underwent spinal anesthesia for rectal surgery. The patients were randomized into two groups. One group (n = 28) received low-dose IT lidocaine (15 mg) and sufentanil (10 µg) and the other group (n = 21) received IT lidocaine (50 mg). The time to ambulation, the incidence of pruritus, and other variables were recorded. Statistical difference was assumed if P < 0.05.

Results: Our results show a significantly shorter ambulation time (120 ± 26 min) after IT low-dose lidocaine (15 mg) and 10 µg sufentanil vs 50 mg IT lidocaine (162 ± 32 min, P < 0.0001). Patients who received IT lidocaine and sufentanil recovered faster. Fifty percent of the patients who received IT sufentanil suffered from pruritus.

Conclusion: IT lidocaine (15 mg) and sufentanil resulted in a shorter time to ambulation compared to IT lidocaine (50 mg) alone and provided excellent anesthesia despite its disadvantage of pruritus.

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