European Journal of Anaesthesiology



Original Article
(RD) Surgery

Restricted spinal anaesthesia for ambulatory surgery: a pilot study


K. S. Kuusniemi a1c1, K. K. Pihlajamäki a1, J. K. Irjala a1, P. W. Jaakkola a1, M. T. Pitkänen a1 and J. E. Korkeila a1
a1 Department of Anaesthesiology, University of Turku, Kiinamyllynkatu 4–8, 20520 Turku, Finland

Article author query
kuusniemi ks   [PubMed][Google Scholar] 
pihlajamäki kk   [PubMed][Google Scholar] 
irjala jk   [PubMed][Google Scholar] 
jaakkola pw   [PubMed][Google Scholar] 
pitkänen mt   [PubMed][Google Scholar] 
korkeila je   [PubMed][Google Scholar] 

Abstract

The increasing use of ambulatory surgery requires methods of anaesthesia that allow patients to be discharged soon after the operation is completed. Spinal anaesthesia is usually simple and quick, and the incidence of post-spinal headache has been reduced by using non-cutting small-gauge needles. Limiting the spread of spinal anaesthesia, as long as it still provides analgesia for surgery, should reduce the haemodynamic effects and speed recovery. Restricted spinal anaesthesia, intended to be unilateral using 0.18% hypobaric bupivacaine via a 25G or 27G Whitacre unidirectional needle, was compared with epidural anaesthesia (using a mixture of lignocaine and prilocaine) in 64 matched-pair patients undergoing ambulatory arthroscopy. Motor blockade, assessed for the specific myotomes L2 to S1, was significantly more unilateral in the spinal group. Two patients in the spinal group and nine patients in the epidural group were treated for hypotension (P < 0.05). One patient in the spinal group developed a post-spinal headache. One patient in the epidural group rated the anaesthesia poor.

(Published Online August 16 2006)
(Accepted July 1998)


Key Words: anaesthetic techniques; spinal; unilateral; epidural; anaesthetics; local; bupivacaine; hypobaric; surgery; ambulatory; knee; arthroscopy.

Correspondence:
c1 Correspondence: K. S. Kuusniemi.