Abstract: Small-dose intrathecal lidocaine versus ropivacaine for anorectal surgery in an ambulatory setting.

Authors:

Buckenmaier CC 3rd, Nielsen KC, Pietrobon R, Klein SM, Martin AH, Greengrass RA, Steele SM.

Institution:

Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.

Source:

Anesth Analg. 2002 Nov;95(5):1253-7

Abstract:

Spinal anesthesia with the local anesthetic lidocaine has come under scrutiny because it is associated with transient neurologic symptoms (TNS). We designed this study to prospectively compare the efficacy of ropivacaine as an alternative to lidocaine in patients undergoing elective outpatient anorectal procedures. Seventy-two patients were randomized to receive either hyperbaric lidocaine 25 mg with fentanyl 20 microg (n = 37) or hyperbaric ropivacaine 4 mg with fentanyl 20 microg (n = 35). Patients were examined for motor block, sensory block, and block duration. Patients were contacted at 24, 48, 72, and 168 h and questioned about their perceptions of pain after the spinal with specific questions designed to diagnose TNS. There were no patients with TNS in either group. There was no significant difference between the lidocaine and ropivacaine groups in any of the outcomes studied. In conclusion, intrathecal hyperbaric small-dose ropivacaine with fentanyl is an acceptable anesthetic for anorectal surgery. IMPLICATIONS: In this prospective trial, small-dose ropivacaine with fentanyl was as effective as small-dose lidocaine with fentanyl for anorectal procedures in the ambulatory setting.

Keywords:

General Surgery Anaesthesia Analgeisia Regional Spinal Anorectal