Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures

Abstract

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (P = 0.027). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy (P = 0.017 and P = 0.007, resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10 cm3 exhibited a VAS score >3 at 8 h and 24 h (P = 0.050, P = 0.036, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification.

The Effect of Spinal versus General Anesthesia on Quality of Life in Women Undergoing Cesarean Delivery on Maternal Request

“…Therefore, a successful spinal anesthesia with an appropriate dose of bupivacaine even without an opioid, guarantees immediate post-operative pain relief. In a previous study, spinal anesthesia was shown to be more effective than general anesthesia in terms of pain control during the first two hours post-operatively in transurethral procedures [21]. This is in agreement with our findings in patients with SAG who reported less pain scores immediately after CS.…”

Comparison of general versus isolated regional anesthesia in total shoulder arthroplasty: A retrospective propensity-matched cohort analysis

“…Despite these advantages however, GA by itself is inadequate at providing local pain control in the immediate post-operative period. 13 Furthermore, because GA suppresses normal autonomic functions (including breathing and cardiac responses), 14 an anesthesiologist must be vigilant in monitoring patient vitals and controlling breathing through an endotracheal device. Previous authors have suggested that cerebral hypoperfusion is potentiated by inhalational agents used in GA, 15 and a clinical trial by Koh et al found that cerebral deoxygenation events were significantly more likely with GA as compared to isolated RA.…”

Postoperative pain after total abdominal hysterectomy and bilateral salpingo-oophorectomy depending on the type of anaesthesia administration

“…It was observed that, statistically (P D 0.027), patients who received general anaesthesia experienced higher intensity of pain than those who administered spinal anaesthesia. [21] In our research, 45.6% of the patients felt severe pain, 33.3% of them felt moderate pain and only 21.1% felt mild pain. We observed that the average intensity of pain according to the NRS was 6.16 § 2.51 and the mean value of severe pain was 8.26 § 1.10 during the first 24 h after the procedure.…”

“…Two weeks after discharge, 69% of the patients with spinal anaesthesia and 48% of those with general anaesthesia, said that they did not have pain (P D 0.04). [20] Two years later, Tyritzis et al [21], in their article in ISRN Urology, analysed the effect of the chosen anaesthesia type on the intensity of postoperative pain. The study group consisted of 94 patients who had undergone resections of bladder tumour and 47 patients who required surgical treatment of prostate adenoma.…”