Spinal Anesthesia for Ambulatory Surgery Using Hyperbaric Prilocaine vs Hyperbaric Bupivacaine: A Prospective Study

Background Spinal anesthesia is a suitable technique for ambulatory surgery, offering benefits such as rapid recovery and minimal complications. The choice of local anesthetic is a key factor in achieving a rapid turnover in an ambulatory surgery unit. This study compares the safety and effectiveness of hyperbaric prilocaine and hyperbaric bupivacaine in an ambulatory setting. Methods A total of 114 patients undergoing ambulatory surgery were randomly allocated to receive either hyperbaric prilocaine (20mg/mL) or hyperbaric bupivacaine (5mg/mL). Time to first walk, time to discharge, and perioperative complications were compared. Results Eighty-nine patients were analyzed: the median time to first unassisted ambulation was significantly reduced by 41 minutes in the prilocaine group, and the average discharge time was reduced by 29 minutes. Hypotension was the most frequently observed complication, occurring in 17.4% of the prilocaine group and 16.3% of the bupivacaine group, with no statistically significant difference. There was no statistically significant difference between the two groups in other perioperative complications studied. Conclusion Hyperbaric prilocaine is a safe and effective alternative to hyperbaric bupivacaine for ambulatory surgery, offering a rapid onset and intermediate duration, resulting in earlier patient discharge. Improving the perioperative times can make the ambulatory unit more efficient and contribute to cost reduction.