Publication:

Use of a local anesthetic and opioid combination in spinal anesthesia in short urologic surgeries

Background To investigate how low-dose levobupivacaine affects both surgical comfort and hemodynamics in patients undergoing short urologic procedures using spinal anesthesia.

Methods Our study was conducted prospectively and double-blind. The study group comprised 40 patients aged 18-65 years from the ASA I-III risk group who had undergone short urological interventions, randomly split into two groups. Informed consent and ethics committee approval were received. Using a media approach and placed in the lateral decubitus position, the patients were given spinal anesthesia using 22 G catheter. Group L was given 1.5ml of levobupivacaine (7.5mg) at 0.5% concentration +0.5ml of saline. Group LF was given 1.2ml levobupivacaine (6mg) at 0.5% concentration +25μg fentanyl (0.5ml) +0.3ml saline. Patient data including peripheral oxygen saturation; systolic, diastolic, mean arterial pressure; time to first postoperative need for analgesics, and spinal block characteristics were recorded at 3, 5, 10, 15, 30, 60, 120 and 360minutes after spinal anesthesia.

Results No significant differences were observed in the demographic and hemodynamic data between groups. Motor blocks were seen to wear off more in Group LF than in Group L at 120minutes. Group LF required first postoperative analgesics later than Group L; this difference was not significant.

Conclusions Sufficient anesthesia was achieved in both groups via spinal block using local anesthetic or local anesthetic plus opioid for relatively short urological procedures. The latter group recovered faster.