Spinal Anesthesia by Hyperbaric Prilocaine in Day-Case Perianal Surgery
Spinal Anesthesia by Hyperbaric Prilocaine in Day-Case Perianal Surgery: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Day-case spinal anesthesia with short-acting local anesthetics such as lidocaine and chloroprocaine can provide short times to discharge. However, the association of lidocaine with transient neurologic symptoms (TNS) and chloroprocaine with neurologic injury has limited the use of these agents in spinal anesthesia.
Hyperbaric bupivacaine has been used for spinal anesthesia for decades owing to the low incidence of TNS.
Prilocaine is also an amide local anesthetic that has an intermediate duration of action. It is available in the hyperbaric form that can be used for spinal anesthesia in day-case surgeries.
Hyperbaric prilocaine provides faster spinal block onset and earlier patient recovery in ambulatory surgery compared to plain prilocaine.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Mohammed S Elsharkawy, MD
- Phone Number: 00201148207870
- Email: mselsharkawy@med.tanta.edu.eg
Study Locations
-
-
El-Gharbia
-
Tanta, El-Gharbia, Egypt, 31527
- Tanta University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age from 18 to 65 years.
- Both sexes.
- American Society of Anesthesiology (ASA) physical status I-II.
- Scheduled for perianal surgery under spinal anesthesia.
Exclusion Criteria:
- Allergy to the studied drugs.
- Patients with contraindications to spinal anesthesia.
- Patients with advanced cardiac, renal, or hepatic diseases.
- Previous voiding difficulty.
- Patients taking anticholinergic medications.
- Time of surgery exceeds 75 min.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Hyperbaric prilocaine group
Patients will receive 1.5 ml (30 mg) 0.5% hyperbaric prilocaine.
|
Patients will receive 1.5 ml (30 mg) 0.5% hyperbaric prilocaine.
|
|
Active Comparator: Hyperbaric bupivacaine group
Patients will receive 1.5 ml (7.5 mg) 0.5% hyperbaric bupivacaine.
|
Patients will receive 1.5 ml (7.5 mg) 0.5% hyperbaric bupivacaine.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time till home readiness
Time Frame: 24 hours postoperatively
|
The time-to-home readiness will be assessed as the time from the end of surgery until the patients reached a post-anesthesia discharge score (PADS) ≥9 and were able to void spontaneously or receive a urinary catheter, and the sensory block resolved to the S3 dermatome.
|
24 hours postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to block regression
Time Frame: 6 hours postoperatively
|
The time to block regression will be from intrathecal injection until sensation is regained at the S1 dermatome.
|
6 hours postoperatively
|
|
Time of onset of motor block
Time Frame: Intraoperatively
|
The time of onset of the motor block will be assessed from intrathecal injection of local anesthetic until a grade 3 Bromage score is achieved
|
Intraoperatively
|
|
Time to spontaneous voiding
Time Frame: 24 hours postoperatively
|
Time to spontaneous voiding will be recorded.
|
24 hours postoperatively
|
|
Time to the 1st rescue analgesia
Time Frame: 24 hours postoperatively
|
Time to the first request for the rescue analgesia will be recorded from end of surgery to first dose of pethidine administrated
|
24 hours postoperatively
|
|
Total ketorolac consumption
Time Frame: 24 hours postoperatively
|
Total ketorolac consumption will be recorded.
If the numerical rating scale (NRS) becomes ≥3, 30 mg ketorolac IM will be given when needed (maximum every six hours).
|
24 hours postoperatively
|
|
Heart rate
Time Frame: Every 10 min till the end of surgery (up to 1 hour)
|
Heart rate will be recorded throughout the operation: every 5 minutes for the first 15 minutes and every 10 minutes until the end of the surgery.
|
Every 10 min till the end of surgery (up to 1 hour)
|
|
Mean arterial pressure
Time Frame: Every 10 min till the end of surgery (up to 1 hour)
|
Mean arterial pressure will be recorded throughout the operation: every 5 minutes for the first 15 minutes and every 10 minutes until the end of the surgery.
|
Every 10 min till the end of surgery (up to 1 hour)
|
|
Incidence of adverse events
Time Frame: 24 hours postoperatively
|
Incidence of adverse events such as postoperative nausea and vomiting (PONV), voiding difficulty, or any other complication.
|
24 hours postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 36264PR839/9/24
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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