[Restricted dorsal spinal anesthesia for ambulatory anorectal surgery: a pilot study.]

The increasing number of ambulatory procedures requires anesthetic methods allowing patients to be discharged soon after surgery completion. Currently, anorectal procedures are performed in inpatient settings. This study aimed at evaluating the feasibility of performing these procedures in outpatient settings with low hypobaric bupivacaine doses.

Participated in this study 30 patients physical status ASA I and II, submitted to spinal anesthesia with 0.15% hypobaric bupivacaine with 27G Quincke needle for anorectal procedures. Spinal puncture was performed with patients in the prone position with the help of a pad under the abdomen to correct lumbar lordosis and the vertebral interspace.

Sensory block was obtained in all patients. Sensory block spread varied T10 to L2 (mode = T12). Only three patients presented motor block. Blockade length was 122.17 +/- 15.35 minutes. No hemodynamic changes were observed in all patients. No patient developed post-dural puncture headache.

Hypobaric bupivacaine (6 mg) has provided predominantly sensory block after injection in the prone position. Major advantages were hemodynamic stability and patients' satisfaction, being a good indication for outpatient anesthesia.