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Spinal Anesthesia for Ambulatory Surgery Using Hyperbaric Prilocaine vs Hyperbaric Bupivacaine: A Prospective Study
Nelson Gomes1, Ana Castro1, Sandra Borges1
1Anesthesiology, Unidade Local de Saúde de Entre Douro e Vouga, Santa Maria da Feira, PRT.
Cureus
|March 3, 2025
Summary
Hyperbaric prilocaine offers faster ambulation and discharge times for ambulatory surgery patients compared to bupivacaine. This spinal anesthesia choice enhances surgical unit efficiency and potentially reduces costs.
Area of Science:
- Anesthesiology
- Ambulatory Surgery
Background:
- Spinal anesthesia is ideal for ambulatory surgery due to rapid recovery and fewer complications.
- Local anesthetic choice significantly impacts turnover time in ambulatory surgery units.
Purpose of the Study:
- To compare the safety and efficacy of hyperbaric prilocaine versus hyperbaric bupivacaine for ambulatory surgery.
- To evaluate the impact of local anesthetic choice on patient recovery and discharge times.
Main Methods:
- 114 patients undergoing ambulatory surgery were randomized to receive either hyperbaric prilocaine (20mg/mL) or hyperbaric bupivacaine (5mg/mL).
- Key metrics included time to first unassisted ambulation, time to discharge, and incidence of perioperative complications.
Main Results:
- The prilocaine group showed a significant reduction in median time to first unassisted ambulation (41 minutes) and average discharge time (29 minutes).
- Hypotension occurred in 17.4% of the prilocaine group and 16.3% of the bupivacaine group, with no significant difference.
- No significant differences were observed in other studied perioperative complications between the two anesthetic groups.
Conclusions:
- Hyperbaric prilocaine is a safe and effective alternative to hyperbaric bupivacaine for ambulatory surgery.
- Prilocaine's rapid onset and intermediate duration facilitate earlier patient discharge, improving ambulatory unit efficiency and cost-effectiveness.
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