Optimized Method of Unilateral Spinal Anesthesia: A Double-blind, Randomized Clinical Study

Area of Science:

• Anesthesiology
• Neurosurgery
• Surgical Innovation

Background:

• Unilateral spinal anesthesia (USpA) often presents technical challenges, including multiple attempts and complications.
• Dural puncture complications can lead to insufficient anesthesia and patient discomfort.

Purpose of the Study:

• To compare the efficacy and safety of conventional USpA versus USpA with electrical nerve stimulation (USpA+ENS).

Main Methods:

• 134 patients undergoing lower extremity vascular surgery were randomized into two groups.
• One group received standard USpA, while the other received USpA+ENS with 7.5 mg Bupivacaine-Spinal®.
• Primary outcomes included post-dural puncture headache (PDPH), puncture attempts, lateralization, and anesthesia adequacy.

Main Results:

• The USpA+ENS group demonstrated a significantly lower frequency of puncture complications compared to the standard USpA group.
• Anesthesia adequacy, pain scores, and secondary outcomes showed comparable results between the groups, with minor variations.

Conclusions:

• USpA+ENS effectively reduces the incidence of puncture complications associated with unilateral spinal anesthesia.
• The integration of electrical nerve stimulation enhances anesthesia quality and improves adherence to the USpA technique for both patients and clinicians.