Effect of Spinal Anesthesia by Prilocaine 2% versus Lidocaine 2% and Bupivacaine 0.5% in Day-Case Lower Abdominal Surgery Outcome

Abstract Background: Ambulatory anesthesia and surgery have attracted growing interest in the past few years, and conse-quently the number of drugs available for outpatient spinal anesthesia has increased. Therefore, a rapid improvement from anesthesia, resulting in an early release, and fast resump-tion of on daily basis activities, could be of great benefit to patients, surgeons, and hospital stay [1]. Aim of Study: The main objective of the present study is to examine the outcome of intrathecal anesthesia with 2% prilocaine against intrathecal anesthesia with bupivacaine 0.5% and 2% lidocaine for lower abdominal day-case surgery. Patients and Method: Sixty-six (66) patients were assigned to spinal anesthesia and randomly divided into three groups with either 2% prilocaine (P group), 0.5% bupivacaine (B group), and 2% lidocaine (L group). The primary outcome as onset of the block, sensory level and motor recovery (Bromage score), voiding time, time to ambulation, time of home read-iness. The secondary outcome as discharge scoring system (White fast and Aldrete discharge score), complications and side effects such as vomiting, nausea, urinary difficulties, as well as (TNS) transient neurological symptoms were monitored prior tohospital discharge and followed-up by telephone for up to one week. Results: In all groups, onset of sensory block, time to return of motor and sensory functions, and ambulation time were significantly shorter in prilocaine (P group), and lidocaine (L group) than in bupivacaine (B group) (p-value <0.05). Moreover, shorter time to spontaneous voiding has been detected after prilocaine, and lidocaine than bupivacaine p< 0.001. Conclusion: A faster recovery time has been found with prilocaine and lidocaine groups, making anesthesia a good alternative for lower abdominal surgery as day case surgery and patient outcome after discharge from the hospital. How-ever, TNS limits the use of lidocaine.