Spinal Anesthesia Using Hyperbaric Prilocaine 2% versus Hyperbaric Bupivacaine 0.5% for Day case Surgery

Abstract

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.