Spinal anaesthesia for brachytherapy for carcinoma of the cervix: a comparison of two dose regimens of hyperbaric bupivacaine

Haus, Nikolas Jason; Kambarami, Tim; Dyer, Robert A.

doi:10.1080/22201173.2013.10872915

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Spinal anaesthesia has been frequently used for cervical brachytherapy as shown by a study conducted by Haus NJ and colleagues, who compared two different doses of spinal anesthesia for the said procedure. They found out that is essential to ensure adequate motor block for successful completion of the procedure 3 . Other forms of regional anesthesia like caudal epidural has also been used for the given procedure as shown by Yoko IS, who found caudal epidural very successful in reducing procedural pain when compared with control groups 4 .…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic Management of Patients for Brachytherapy in Radiation Suite

Bashir¹,

Azhar²,

Azam³

2022

PJMHS

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Background: Cervical cancer is one of the leading sites for cancer in female patients and brachytherapy remains one of the treatment modality for it. Anaesthetic services are required in certain cases. Anaesthesia services outside operating room pose challenges for anaesthesiologists due to remote access need for slave monitors etc. Aim: To evaluate the outcome of different anaesthetic techniques in female patients undergoing cervical brachytherapy procedures in radiotherapy department. Methods: This retrospective cross-sectional analysis conducted at a tertiary care cancer centre of Shaukat Khanum Memorial Trust Lahore. Anaesthetic details of all female patients planned for brachytherapy over a time period of three years from 2016 to 2018 was recorded. The subjects were female patients for the given procedure. Their mean age in years, ASA status, anaesthetic technique either General anaesthesia or Spinal anaesthesia in terms of patient number and percentage of total patients for either, any complication related to anaesthetics was recorded. Chi square test was applied to see any correlation between anaesthetic technique and complications. Results: There were 87 female patients in this research having mean age of 51±15 years. Regarding ASA physical status, 27(31%) of ASA status II while 60(69%) patients of ASA status III. General anaesthesia was given to 33(38%) patients, while 54(62%) patients received spinal anaesthesia. Overall, complications rate remained 7% and it was less in spinal anaesthesia (2%) as compared to general anaesthesia (8%) with statistically significant p-value of 0.001 Conclusions: We concluded that cervical brachytherapy can be safely conducted under spinal anaesthesia in radiation suite. Keywords: Brachytherapy, spinal anaesthesia, general anaesthesia, anaesthesia outside OR.

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Section: Discussionmentioning

confidence: 99%

Anaesthetic Management of Patients for Brachytherapy in Radiation Suite

Bashir¹,

Azhar²,

Azam³

2022

PJMHS

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“…2,3 Spinal anesthesia (SA) is the choice because it has an easy implementation technique, fast onset, and low complications compared to general anesthesia. 4 SA as a form of regional anesthesia has been widely used in short surgical procedures, including cystoscopy. SA has several advantages compared to general anesthesia, including reduced stay in the postanesthesia care unit (PACU), as well as better postoperative pain and less nausea / vomiting.…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial comparing the recovery time after spinal anesthesia with 2% hyperbaric prilocaine 50 mg vs. 0.5% hyperbaric bupivacaine 12.5 mg for cystoscopic procedures

Tantri,

Nathanael Marbun,

Heriwardito

2023

Anaesth. pain intensive care

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Background: Cystoscopy is a urologic procedure performed as a diagnostic or a therapeutic intervention, usually requiring spinal anesthesia (SA). Bupivacaine is a frequently used spinal anesthesia agent. However, the prolonged duration of its effect is a disadvantage. Prilocaine may be an alternative for spinal anesthesia in cystoscopy, which has a shorter duration of action compared to bupivacaine. We compared recovery time of 2% hyperbaric prilocaine 50 mg vs. 0.5% hyperbaric bupivacaine 12.5 mg for cystoscopic procedures under spinal anesthesia. Methods: This study was a randomized controlled trial involving 66 patients who underwent cystoscopy in Dr. Cipto Mangunkusumo National General Hospital under SA. Subjects were randomized into two groups, i.e. prilocaine group to receive SA with hyperbaric prilocaine 2% 50 mg + fentanyl 25 µg and bupivacaine group to receive hyperbaric bupivacaine 0.5% 12.5 mg + fentanyl 25 µg. Following SA, the time to lift the leg 45 degrees and time to regain the ability to walking unsupported were noted in both groups and statistically compared. Hemodynamic changes in SpO2 and NIBP at fixed periods, as well as adverse effects were recorded. Results: Hemodynamic changes and adverse effects were comparable between the two groups. The mean time to lift a leg 45 degrees (93.88 min vs. 180.36 min; P < 0.001) and the time until the patient walked (144.91 min vs. 259.76 min; P < 0.002) were significantly short in the prilocaine group. The mean regression time for prilocaine and bupivacaine SA was 69.36 ± 35.85 and 131.88 ± 79.43 min respectively; the difference being significant (P < 0.001). Conclusion: Hyperbaric prilocaine 2% has a shorter recovery period when compared to hyperbaric bupivacaine 0.5% for spinal anesthesia and is appropriate for the length of the cystoscopy, making it a viable spinal anesthetic option. Keywords: Bupivacaine; Cystoscopy; Prilocaine; Anesthesia, Spinal; Recovery Time Citation: Tantri AR, Marbun JCRN, Heriwardito A. A randomized controlled trial comparing the recovery time after spinal anesthesia with 2% hyperbaric prilocaine 50 mg vs. 0.5% hyperbaric bupivacaine 12.5 mg for cystoscopic procedures. Anaesth. pain intensive care 2023;27(6):689−696; DOI: 10.35975/apic.v27i6.2145 Received: January 29, 2023; Reviewed: October 23, 2023; Accepted: October 23, 2023

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“…9 One of the disadvantages of spinal anesthesia using pure local anesthetics is that the duration of action is relatively short, so the effect on postoperative analgesia is shorter and thus requires analgesic intervention in the postoperative period. 12,13 A number of adjuvants, such as clonidine and midazolam, have been studied to prolong the effects of spinal anesthesia. 14 These adjuvants include a variety of opioid and nonopioid drugs.…”

Section: Introductionmentioning

confidence: 99%

Spinal Anesthesia Ambulation Time of Cervical Cancer Brachytherapy Outpatient Clinic: Comparison of 5 mg Hyperbaric Bupivacaine Fentanyl with 2,5 mg Hyperbaric Bupivacaine and 25 mcg Fentanyl

DM,

Mafiana R,

Zainal R

et al. 2023

JACR

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Introduction: Regional anesthetic techniques and local anesthesia have proven to be more effective than general anesthesia in the practice of ambulatory anesthesia. Spinal anesthesia is the technique of choice for ambulatory anesthesia in cervical cancer brachytherapy patients. Low-dose local anesthetics can speed up the ambulation time. This study aims to compare the ambulation time of low-dose spinal anesthesia with conventional doses. Fast ambulation time can speed up recovery time for patients, thereby reducing the patient's length of stay. Methods: This study was a double-blind, randomized controlled trial conducted in August – September 2022 at the Radiotherapy Installation of Dr. Mohammad Hoesin General Hospital (RSMH) Palembang. All cervical cancer patients undergoing brachytherapy in adults with ASA I-II physical status were included in the study sample. Samples will be randomized into two groups, namely a combination of hyperbaric bupivacaine 5 mg and fentanyl 25 mcg and a group of bupivacaine 2.5 mg and fentanyl 25 mcg. Patients with allergies, impaired motor function, spinal failure, block level not achieved, shock, apnea, respiratory depression, and experiencing pain during the procedure were excluded from the study. Results: Ambulation time in the hyperbaric bupivacaine 5 mg and 25 mcg fentanyl group was longer than the hyperbaric bupivacaine 2.5 mg and 25 mcg fentanyl (155.22 + 10.68 minutes versus 98.69 + 7.13 minutes) with a significance level of p<0.001. Spinal anesthetic drugs work in a dose-dependent manner. Increasing the dose will increase the duration of action of the spinal anesthetic. The only side effects found were hypotension and pruritus. Conclusion: Spinal anesthesia with hyperbaric bupivacaine 2.5 mg and fentanyl 25 mcg can accelerate the ambulation time of cervical cancer patients undergoing brachytherapy.

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Spinal anaesthesia for brachytherapy for carcinoma of the cervix: a comparison of two dose regimens of hyperbaric bupivacaine

Cited by 4 publications

References 19 publications

Anaesthetic Management of Patients for Brachytherapy in Radiation Suite

Anaesthetic Management of Patients for Brachytherapy in Radiation Suite

A randomized controlled trial comparing the recovery time after spinal anesthesia with 2% hyperbaric prilocaine 50 mg vs. 0.5% hyperbaric bupivacaine 12.5 mg for cystoscopic procedures

Spinal Anesthesia Ambulation Time of Cervical Cancer Brachytherapy Outpatient Clinic: Comparison of 5 mg Hyperbaric Bupivacaine Fentanyl with 2,5 mg Hyperbaric Bupivacaine and 25 mcg Fentanyl

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