Spinal anesthesia using hyperbaric prilocain 2% versus hyperbaric bupivacine 0.5%for day case surgery

Faculty Medicine Year: 2021
Type of Publication: ZU Hosted Pages:
Authors:
Journal: The Egyptian journal of hospital medicine The Egyptian journal of hospital medicine Volume:
Keywords : Spinal anesthesia using hyperbaric prilocain , versus    
Abstract:
Summary Background: Usually, neuromuscular blocking drugs are used for facilitating tracheal intubation but sometimes limitations exist as in procedures where neuromuscular monitoring is required or that of short duration. So, using an alternative method is important for providing good intubating conditions. Patients and methods: Eighty-eight patients in Zagazig University hospitals were randomly divided into two equal groups, group-M (Magnesium group) and group-P (high dose of propofol group). Group (M) received Magnesium sulfate (40 mg/kg), Fentanyl (2 μg/kg) and Propofol (2 mg/kg). Group (P) received Fentanyl (2 μg/kg) and Propofol (3 mg/kg). Assessment of quality of intubation conditions and hemodynamic response to tracheal intubation were done. Results: Group (M) had better intubation score and also less hemodynamic response to endotracheal intubation than group (P). Conclusion: Intravenous infusion of magnesium sulfate (40 mg/kg) before induction leading to better intubation score and also less haemodynamic response to endotracheal intubation than high dose of propofol.   البحث الثاني Journal The Egyptian Journal of Hospital Medicine (April 2022) Vol. 87, Page 1658-1665 Title Spinal Anesthesia Using Hyperbaric Prilocaine 2% versus Hyperbaric Bupivacaine 0.5% for Day case Surgery Authers Rabei Gheth Salem Etriki ; Howaida Kamal Abd Ellatif; Ekram Fawzy Sayouh; Ahmed Mosallam Mohammed Summary Background: Day-case spinal anesthesia with short-acting local anesthetics such as hyperbaric prilocaine, has a short duration of action and the transient neurological symptoms (TNS) incidence is low. Objective: The present study aimed to compare spinal anesthesia using hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% for day case surgery. Patients and Methods: This Prospective randomized controlled double-blind clinical trial study was carried out on 66 patients of both sexes scheduled for day case surgery under spinal anesthesia, They were divided into two groups; group P: received 60mg hyperbaric prilocaine 2%; group C: received 15mg hyperbaric bupivacaine 0.5%. Results: The prilocaine group showed a faster onset time of sensory (1.95 ± 0.36 min) and motor block (4.87 ± 0.7 min) and shorter time to reach maximal sensory block level(p < 0.001). Prilocaine group also provides a shorter duration time of sensory (92.4 ± 2.5min) and motor block (110.7 ± 8.8min) than that of the bupivacaine group (207.6 ± 10.9&253.9 ± 19.8 min) respectively). Prilocaine group showed a statistically significant shorter time to sit (113.3 ±7.7min), stand (121.8±10.5min), walk unassisted (130.7±7.8 min) and void spontaneously (256.4±21.5 min) compared to the corresponding times in the bupivacaine group, where the time to sit, stand, walk unassisted and void spontaneously were (279.1±14.0 min) (285.5±10.9min), (301.8±13.9min), (345.4±24.5min) respectively. Conclusions: Hyperbaric prilocaine provides faster onset time, shorter duration of action, and earlier patient recovery in ambulatory surgery compared to hyperbaric bupivacaine in day-case surgery.
   
     
 
       

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