Short-acting spinal anesthesia in the ambulatory setting

Förster, J. G.

doi:10.1097/aco.0000000000000126

Cited by 36 publications

(23 citation statements)

References 38 publications

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“…[41][42][43] Given the increasing proportion of anesthesia administered in the ambulatory setting, 44,45 there is demand for anesthetic techniques which allow for rapid recovery with minimal side effects. 46,47 The demand for low-dose spinal techniques in ambulatory surgery highlights the need for additional studies focusing on nonobstetric populations. Low-dose spinal anesthesia is also of interest for those obstetric patients who may not tolerate spinal hypotension.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Ondansetron for the Prevention of Intrathecal Fentanyl- or Sufentanil-Mediated Pruritus

Prin

Guglielminotti²,

Moitra

et al. 2016

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 99%

Prophylactic Ondansetron for the Prevention of Intrathecal Fentanyl- or Sufentanil-Mediated Pruritus

Prin

Guglielminotti²,

Moitra

et al. 2016

Anesthesia &Amp; Analgesia

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“…In this sense, subarachnoid anesthesia could represent an excellent option, provided that appropriate drugs and technique are employed. But in truth, the latest techniques in anesthesia, which provide for unilateral anesthetic blockage 5 and low doses of short-acting drugs [6,7], enable to minimize disadvantages classically related to this kind of anesthetic technique and to achieve an earlier…”

Section: Introductionmentioning

confidence: 99%

Tailored surgery in inguinal hernia repair. The role of subarachnoid anesthesia: a retrospective study

et al. 2019

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AbstractSafety and effectiveness evaluation of subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose (30mg) in combination with Fentanyl (20mcg), for the purpose of ensuring an optimal analgesia in open inguinal hernia repair.Although the local anesthesia is the first line treatment for open inguinal hernia repair, a minority of patients is not eligible because of obesity or big groin hernia, requiring a high dose of local anesthetic. Subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose in combination with Fentanyl may be a good alternative.Thirty patients were treated with intrathecal association of Prilocaine 30 mg and Fentanyl 20 mcg (group PF); they were compared to a group of fifty three ones, previously treated with a classic procedure with intrathecal Prilocaine 60 mg (group P).The sensitive blockage remained within an higher limit at T12 level in the patients of PF group, and a lower limit at S1 level 50 minutes after the anesthesia, while in the P group the anesthetic tended to migrate (p<0.0001). In PF group 70 minutes after the anesthesia 21 patients had a Bromage score equal to 0 and 9 patients equal to 9 (in P group, 19 patients had a score equal to 3, 8 to 2 and 3 to 1, p<0.0001).Subarachnoid anesthesia using Prilocaine 30 mg + Fentanyl 20 mcg could be stated as a viable alternative to local anesthesia in selected patients.

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“…An ideal outpatient spinal anesthetic would provide rapid sensory and motor block, predictable regression and a low incidence of side effects 1. For many years this profile has been fulfilled by lidocaine but, in 1993, “transient neurologic symptoms” (TNS) were described as adverse events in patients after a single spinal injection of lidocaine 2,3.…”

Section: Introductionmentioning

confidence: 99%

Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review

Manassero¹,

Fanelli²

2017

LRA

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Prilocaine is a local anesthetic characterized by intermediate potency and duration and fast onset of action. As hyperbaric formulation of 5% solution, it was introduced and has been successfully used for spinal anesthesia since 1960. A new formulation of 2% plain and hyperbaric solution is currently available in Europe. Because of its lower incidence of transient neurological symptoms, prilocaine is suggested as substitute to lidocaine and mepivacaine in spinal anesthesia for ambulatory surgery, as well as a suitable alternative to low doses of long-acting local anesthetics. The National Library of Medicine database, the Excerpta Medica database, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials database, were searched for the period 1970 to September 2016, with the aim to identify studies evaluating the intrathecal use of 2% prilocaine. A total of 13 randomized clinical trials (RCTs), 1 observational study, 2 dose finding, and 4 systematic reviews has been used for this review. The studies evaluated showed that 2% hyperbaric prilocaine due to a favorable anesthetic and safety profile is an alternative drug to lidocaine and mepivacaine for spinal anesthesia of intermediate or short duration. In comparison with plain solutions, hyperbaricity remarkably accelerates the onset and offset times of intrathecal 2% prilocaine. Literature suggests a dose ranging between 40 and 60 mg of prilocaine for lower extremities and lower abdominal procedures lasting up to 90 min, whereas a dose ranging from 10 to 30 mg is appropriate for perineal surgery. Readiness for discharge occurs in ~4 h from spinal administration.

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Short-acting spinal anesthesia in the ambulatory setting

Cited by 36 publications

References 38 publications

Prophylactic Ondansetron for the Prevention of Intrathecal Fentanyl- or Sufentanil-Mediated Pruritus

Prophylactic Ondansetron for the Prevention of Intrathecal Fentanyl- or Sufentanil-Mediated Pruritus

Tailored surgery in inguinal hernia repair. The role of subarachnoid anesthesia: a retrospective study

Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review

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