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Insertion under local anaesthetic of temporary electrodes for sacral nerve stimulation testing is reliable and cost
P J Mitchell1, K Cattle, S Saravanathan
1Pelvic Floor Service, Department of General Surgery, University Hospital South Manchester NHS Trust, Manchester, UK.
Aim:
The aim of this study was to determine whether temporary electrode implantation under local anaesthesia (LA), with reliance on sensory response rather than motor response, gives as good a result as implantation under general anaesthesia (GA).
Method:
A retrospective review of a prospectively maintained database of patients with faecal incontinence treated with sacral nerve stimulation (SNS) was performed.
Results:
A total of 111 consecutive patients underwent a 2-week trial of SNS. Forty-seven (42%) had the temporary electrode implanted under LA and 64 (58%) under GA. There was no significant difference between the two groups in relation to the improvement in Vaizey score (P = 0.15), incontinent episodes per day (P = 0.73) and incontinent episodes per week (P = 0.93). There was no significant difference (P = 0.14) in the percentage of successful trials between the LA group (64%) and the GA group (77%); however, only 62% of the GA group were discharged home on the same day when compared with 89% of the LA group (P < 0.0001).
Conclusion:
Similar success rates for temporary trial with SNS can be achieved with LA and GA. Insertion under LA is associated with reduced cost, shorter hospital stay and quicker recovery, and it avoids the risk of general anaesthesia.