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Multimodal spinal anesthesia
Ghassan E Kanazi1, Son B Tran, Laudia Rizk
1Department of Anesthesiology, American University of Beirut, Beirut-Lebanon.
Middle East Journal of Anaesthesiology
|September 25, 2003
Summary
This study found that a combination of sufentanil, clonidine, and reduced-dose lidocaine provided effective spinal anesthesia for urologic procedures like cystoscopy and extracorporeal shock wave lithotripsy (ESWL). Patients experienced good pain relief and quick motor recovery with minimal side effects.
Area of Science:
- Urology
- Anesthesiology
- Pharmacology
Background:
- Cystoscopy and extracorporeal shock wave lithotripsy (ESWL) are common urologic procedures.
- Spinal anesthesia using local anesthetics is preferred for these procedures.
- Sufentanil and clonidine are often combined with local anesthetics for enhanced neuroaxial anesthesia.
Purpose of the Study:
- To evaluate the efficacy and safety of combining sufentanil and clonidine with reduced doses of intrathecal lidocaine.
- To assess this anesthetic combination in patients undergoing cystoscopy and ESWL.
Main Methods:
- A retrospective review of 12 patients who received an intrathecal mixture of 20 mg lidocaine, 10 mcg sufentanil, and 50 mcg clonidine.
- Data collected included patient demographics, intraoperative analgesia, adverse effects, and recovery times.
Main Results:
- All 12 patients tolerated the procedures without needing alternative anesthesia or significant intravenous analgesic supplementation.
- Motor power returned to normal by the end of the procedures.
- Mild hypotension was the most frequent side effect; recovery time in the postanesthesia care unit was short (45 ± 15 minutes).
Conclusions:
- Intrathecal sufentanil, clonidine, and lidocaine provide effective, prolonged analgesia for cystoscopy and ESWL.
- Patients achieved timely motor function recovery without urinary retention.
- Mild hypotension was the primary adverse effect, influencing discharge time.