Comparison of recovery profile in selective spinal anaesthesia using lignocaine and sufentanyl with propofol based general anaesthesia for gynaecological laparoscopy surgery: a randomized controlled study

ABSTRACT

To compare the recovery characteristics of selective spinal anaesthesia [SSA] with propofol based GA for short duration outpatient gynaecological laparoscopic surgeries. Prospective, randomized clinical trial. Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India. Conducted from August 2007 to March 2008. This trial was done in forty adult female patients who were randomized in two groups Group GA GA was induced with intravenous fentanyl [2microg/kg] and propofol [2mg/kg]. Airway was secured with proseal laryngeal mask airway. Anaesthesia was maintained with titrated propofol infusion [100-150microg/kg/min], nitrous oxide and oxygen [5050]. Group SSA Patients received subarachnoid block in sitting position with lignocaine 10mg and sufentanyl 10microg to a total volume of 2.5mL with sterile water. Patient remained sitting for 1minute and then in reverse Trendelenburg position for 6-8minutes. Recovery time from the end of surgery and any adverse effects were recorded. Patients demographic profile and duration of surgery were comparable. The time from the end of surgery to exit from operating room, time to straight leg raising and deep knee bend were significantly prolonged in group GA as compared to group SSA. The time to reach a modified Aldrete score>9 was significantly prolonged in group GA as compared to group SSA. The mean time to first analgesic requirement postoperatively was significantly longer for group SSA as compared with group GA. SSA could effectively be used for patients undergoing short duration outpatient gynecological laparoscopy as compared to propofol infusion based general anaesthesia