Spinal Anaesthesia for Endoscopic Urological Surgery: A Comparison of 2% Hyperbaric Prilocaine with 0,5% Hyperbaric Bupivacaine

Background and aims: Hyperbaric prilocaine is a short-acting local anaesthetic. The aim of this study is to compare the characteristics of subarachnoid block using hyperbaric prilocaine with that of bupivacaine in outpatients undergoing transurethral resection of bladder (T.U.R.B.). Methods: In this prospective randomized controlled trial, 60 patients undergoing endoscopic urological surgery received subarachnoid anaesthesia with either 2% hyperbaric prilocaine 60 mg (Group P) or 0,5% hyperbaric bupivacaine 15 mg (Group B). Recovery time from motor block was defined as the primary outcome variable. Secondary outcomes considered were: onset of sensory and motor block and adverse events like hypotension, bradycardia, nausea, pruritus. Motor block was assessed using the Bromage scoring system. A global patient satisfaction score was also obtained using the five points Likert scale. Results: Onset time of sensory and motor block was faster in the group that received prilocaine. The duration of sensory block was also shorter in the prilocaine. Time to full motor function recovery was shorter after prilocaine than bupivacaine. Incidence of side effects like hypotension and bradicardia was significantly higher in bupivacaine group. Conclusion: This study demostrated that intrathecal prilocaineis an alternative with a favourable recovery profile for use intransurethral resection of bladder.