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General anaesthesia or spinal anaesthesia for outpatient urological surgery

Published online by Cambridge University Press:  12 July 2005

E. Erhan ,
G. Ugur ,
O. Anadolu ,
M. Saklayan  and
B. Ozyar
E. Erhan
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Izmir, Turkey
G. Ugur
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Izmir, Turkey
O. Anadolu
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Izmir, Turkey
M. Saklayan
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Izmir, Turkey
B. Ozyar
Affiliation:
Ege University, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Izmir, Turkey
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Abstract

Summary

Background and objective: A variety of drugs and techniques have been introduced into ambulatory anaesthesia. The technique as well as the drugs used may hasten or delay home discharge. We compared recovery profiles and side-effects of spinal anaesthesia and total intravenous anaesthesia.

Methods: Forty unpremedicated ASA I–II patients (18–65 yr) undergoing varicocele repair were randomly divided into two groups. Spinal anaesthesia (26-G atraumatic needle) with hyperbaric bupivacaine 0.5% 5 mg and fentanyl 25 μg were given to patients in Group Spinal (n = 20). Patients in Group TIVA (n = 20) received total intravenous anaesthesia with propofol and remifentanil given by continuous infusion; a laryngeal mask was used to secure the airway. The duration of surgery, time to home readiness and side-effects were recorded.

Results: The two groups were comparable with respect to patients' characteristics and duration of surgery. The times to achieve ambulation were similar between groups (Spinal = 78.4 ± 40.9 min, TIVA = 75.9 ± 13.8 min). Urinary voiding was a requirement for discharge after spinal anaesthesia and the time for home readiness was longer in Group Spinal (158.0 ± 40.2 versus 94.9 ± 18.8 min) (P < 0.05). Two patients reported pruritus and one reported postdural puncture headache in Group Spinal, whereas two patients reported nausea in Group TIVA. Patients in Group TIVA had a greater need for analgesia postoperation (P < 0.05).

Conclusions: In healthy unpremedicated men undergoing minor urological operations, total intravenous anaesthesia with remifentanil and propofol provided as safe and effective anaesthesia as spinal block with the advantage of earlier home readiness.

Keywords

ANAESTHESIA CONDUCTION, spinal anaesthesiaANAESTHESIA GENERALANAESTHETICS, INTRAVENOUS, propofol, remifentanilANAESTHETICS, LOCAL, bupivacaineSURGICAL PROCEDURES, OPERATIVE, ambulatory surgical procedures
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 8 , September 2003 , pp. 647 - 652
Copyright
2003 European Society of Anaesthesiology

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