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Low Dose Spinal Anesthesia for Ambulatory Surgery of Varicose Vein  

Yang, Jin-Sung (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Sooncheonhyang University College of Medicine)
Park, Young-Woo (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang Gumi University Hospital, Sooncheonhyang University College of Medicine)
Lee, Jae-Wook (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang Gumi University Hospital, Sooncheonhyang University College of Medicine)
Won, Yong-Soon (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Sooncheonhyang University College of Medicine)
Shin, Hwa-Kyun (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Sooncheonhyang University College of Medicine)
Lee, Dong-Gi (Department of Anesthesiology and Pain Medicine, Sooncheonhyang Gumi University Hospital, Sooncheonhyang University College of Medicine)
Publication Information
Journal of Chest Surgery / v.42, no.2, 2009 , pp. 233-237 More about this Journal
Abstract
Background: Bupivacaine with fentanyl might be suitable as the spinal anesthesia for performing ambulatory surgery to treat varicose vein. Material and Method: Thirty patients who underwent spinal anesthesia for a varicose vein operation were enrolled in this study. They were classified into 2 groups of either fentanyl 25ug mixed with bupivacaine 4mg (group FB4) or bupivacaine 8mg (group B8). We compared the groups for the success of the analgesia, the recovery time from sensory and motor block, the side effects and the postoperative complications. Result: The groups did not differ significantly regarding the success of analgesia (13 of 15 [group FB4], 15 of 15 [group B8]). None of the patients were converted to general anesthesia due to surgical pain. None of the patients required medication for hypotension and/or bradycardia. The operative and nonoperative side effects of motor block (tested for by using a modified Bromage scale) was significantly lower in group FB4 than that in group B8, as checked at 2 hours after spinal anesthesia (p<0.05). Recovery from spinal block was significantly quicker in group FB4 than that in group B8 (p<0.05). The first voluntary micturition time did not differ significantly (6.5 hours v 4.5 hours [p=0.143]) between the groups, but a nelatone catheter was inserted into 2 of the group B8 patients due to dysuria. Conclusion: Adequate intraoperative analgesia and hemodynamic stability and faster mobilization were achieved using bupivacaine 4mg with fentanyl 25ug. Low dose spinal anesthesia with fentanyl is suitable for performing ambulatory surgery to treat varicose vein.
Keywords
Varicose vein; Ambulatory surgery; Spinal anesthesia;
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1 Valanne JV, Korhonen AM, Jokela RM, Ravaska P, Korttila KK. Selective spinal anesthesia: a comparison of hyperbaric bupivacaine 4 mg versus 6 mg for outpatient knee arthroscopy. Anesth Analg 2001;93:1377-9   DOI   ScienceOn
2 Wang C, Chakrabarti MK, Whitwam JG. Specific enhancement by fentanyl of the effects of intrathecal bupivacaine on ociceptive afferent but not on sympathetic efferent pathways in dogs. Anesthesiology 1993;79:766-73   DOI   PUBMED
3 Fanelli G, Borghi B, Casati A, et al. Unilateral bupivacaine spinal anesthesia for outpatient knee arthroscopy. Can J Anesth 2002;47:746-51   DOI   ScienceOn
4 Kwak KH, Lee SH, Jeon YH, Moon CW, Baek WY. Comparison of clinical effect of low dose bupivacaine added with fentanyl and conventional dose bupivacaine in spinal anesthesia for a transurethral resection of the prostate. Korean J Anesthesiol 2002;43:418-23
5 Kallio H, Snäll E-VT, Kero MP, Rosenberg PH. A comparison of intrathecal plain solutions containing ropivacaine 20 or 15 mg versus bupivacaine 10 mg. Anesth Analg 2004;99:713-7   DOI   ScienceOn
6 Lis SS, Ware PD, Allen HW, Neal JM, Pollock JE. Dose-response characteristics of spinal bupivacaine in volunteers. Anesthesiology 1996;85:729-36   DOI   ScienceOn
7 Lim YJ, Jung JD, Lim KJ, So KY. Effect of intrathecal fentanyl with hyperbaric bupivacaine on unilateral spinal anesthesia for knee arthroscopy. Korean J Anesthesiol 2006; 50:530-5
8 Dickenson AH. Mechanisms of the analgesic actions of opiates and opioids. Br Med Bull 1991;47:690-702   PUBMED
9 Hamber EA, Viscomi CM. Intrathecal lipophilic opioids as adjuncts to surgical spinal anesthesia. Reg Anesth Pain Med 1999;24:255-63   DOI   PUBMED   ScienceOn
10 Ben-David B, Frankel R, Arzumonov T, Marchevsky Y, Volpin G. Minidose bupivacaine-fentanyl spinal anesthesia for surgical repair of hip fracture in the aged. Anesthesiology 2000;92:6-10   DOI   ScienceOn