Document Detail


Low-dose 3 mg levobupivacaine plus 10 microg fentanyl selective spinal anesthesia for gynecological outpatient laparoscopy.
MedLine Citation:
PMID:  19843783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lidocaine selective spinal anesthesia has been effective for short-duration gynecological outpatient laparoscopy. We compared the intraoperative effectiveness, anesthetic recovery times, and patient satisfaction after levobupivacaine-fentanyl versus lidocaine-fentanyl spinal anesthesia during short-duration gynecological laparoscopy. METHODS: In this double-blind study, 52 healthy women scheduled to undergo tubal sterilization were randomly assigned to receive either intrathecal 10 mg lidocaine 2% plus 10 microg fentanyl (Group I) or intrathecal 3 mg levobupivacaine 0.5% plus 10 microg fentanyl (Group II), each solution made to a total volume of 3 mL with sterile water. The following variables were monitored intraoperatively: anesthesia onset time, need for anesthesia-analgesia supplementation, depth of sedation, surgical conditions, and occurrence of hemodynamic events. After surgery, motor block, proprioception, vibration sense, light touch, and Romberg's test were performed to evaluate whether the patients could bypass the postanesthesia care unit and be allowed to walk by themselves. Sensory block level was determined at 5, 10, and 15 min after anesthetic injection, and then every 15 min until resolution was complete. A difference of 25 min in sensory block resolution time was considered clinically relevant. RESULTS: Onset time and intraoperative conditions were comparable in both groups. No patient required general anesthesia to complete surgery. All patients from both groups bypassed the postanesthesia care unit. Ambulation took place after 27 (18-45) min in Group I and 30 (18-56) min in Group II (P = 0.24). Complete regression of spinal anesthesia occurred after 93 (65-120) min in Group I and 105 (78-150) min in Group II (P = 0.019); however, no differences were observed in time for home discharge 185 (150-300) min in Group I and 188 (125-300) min in Group II (P = 0.62). Global patient satisfaction was comparable between both groups. CONCLUSIONS: Levobupivacaine 3 mg plus 10 microg fentanyl may be used as a suitable alternative to 10 mg lidocaine plus 10 microg fentanyl for spinal anesthesia of short duration. It achieved a clinically equivalent time for resolution of sensory block, similar intraoperative conditions, and comparable patient satisfaction..
Authors:
Jesus de Santiago; Javier Santos-Yglesias; Jorge Giron; Francisco Montes de Oca; Alejandro Jimenez; Pilar Diaz
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  109     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-21     Completed Date:  2009-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1456-61     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Hospital USP La Colina, SC de Tenerife, 38006 Tenerife, Spain. jdesantiago@telefonica.ne
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MeSH Terms
Descriptor/Qualifier:
Adjuvants, Anesthesia / administration & dosage*
Adult
Ambulatory Surgical Procedures*
Anesthesia Recovery Period
Anesthesia, Spinal / methods*
Anesthetics, Local / administration & dosage*
Bupivacaine / administration & dosage,  analogs & derivatives
Double-Blind Method
Female
Fentanyl / administration & dosage*
Hemodynamics / drug effects
Humans
Laparoscopy*
Lidocaine / administration & dosage*
Patient Discharge
Patient Satisfaction
Prospective Studies
Sensation / drug effects
Sterilization, Tubal / methods*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adjuvants, Anesthesia; 0/Anesthetics, Local; 0/levobupivacaine; 137-58-6/Lidocaine; 2180-92-9/Bupivacaine; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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