A comparison of selective and conventional spinal anaesthesia for ambulatory surgery

Selective spinal anaesthesia is the practice of employing minimal doses of intrathecal agents so that only the nerve roots supplying a specific area and only the modalities that require to be anaesthetised are affected. The study is based on the hypothesis that small dose lidocaine spinal anaesthesia may be adequate for elective surgical procedures, providing limited motor and sensory block, and thus enabling earlier patient's discharge. The aim of this study was the comparison of the low and the conventional dose of lidocaine spinal anaesthesia discharge time.

The study was a prospective, randomized controlled single-blind trial, with 84 patients enrolled. Patients in study group (SS-L, Selective Spinal Lidocaine) were administered 3 mL of a 0.8% lidocaine solution containing 24 mg of lidocaine and 15 μg of fentanyl for spinal anaesthesia. Patients in the control group (CD-L, Conventional Dose Lidocaine) received 5 mL of a 1% lidocaine solution containing 50 mg of lidocaine and 25 μg of fentanyl for spinal anaesthesia. Discharge time was evaluated.

In the SS-L group time to discharge were shorter (P < 0.01) compared to the CD-L group.

Selective spinal anaesthesia with low dose of lidocaine decreases the time of patient discharge compared with conventional lidocaine dose spinal anaesthesia.