Anaesthesia for incontinence surgery: spinal anaesthesia or sedation?

This was a patient and assessor blinded randomised controlled trial to compare the patient and surgeon's satisfaction for retropubic tapes inserted under sedation vs spinal anaesthesia and also looking at the bladder sensation following insertion of the tape. A total of 38 patients completed the study (19 in each group). The differences in mean visual analogue scores were in favour of spinal anaesthesia. The surgeon's assessment of patient cooperation was 24.2, 95% CI 9.6-38.8 p = 0.002, while for pain, the difference in the mean scores was -21.6, 95% CI -36.6 to -6.5, p = 0.006. The difference in the mean scores for the feeling of being in control was 21.4, 95% CI 0.85 to 41.63, p = 0.004. The only significant difference in bladder sensation postoperatively was the strong desire to void at 1 hour. This study demonstrates that spinal anaesthesia has better patient and surgeon satisfaction, with a difference in bladder sensation at 1 hour postoperatively.