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ESRA19-0189 Hyperbaric prilocaine for one-day spinal anesthesia: a large cohort retrospective study

Background and aims Hyperbaric 2% prilocaine (HP) is increasingly used for spinal anesthesia in the ambulatory setting. Therefore, there is a need to understand this local anesthetic in terms of administration, efficiency and side effects. In this context, we conducted an observational study on a large panel of patients scheduled for day-case surgery. Methods This retrospective study was approved by the local Medical Ethics Committee. Data (dose of HP, success-failure, time of discharge, EVA (0–10), side effects, satisfaction graded from 0 to 10) were collected based on the electronic patient file. Intrathecal HP was compared to the association HP-sufentanil by using a propensity score after matching groups on the following confounding variables: gender, age, weight, size, BMI, ASA score, type of surgery, posology of HP, analgesics, midazolam. Results Data from 794 patients, ASA-score I to III, 50.44±13.66 years-old were analyzed. Prilocaine was injected solely in 76% of the cases at the dose of 50.25±10.17 mg. Surgery was possible in 90.06% under spinal anesthesia only. Failures were not related to age, size, weight, BMI or intrathecal sufentanil. The time of discharge was decreased by the administration of intrathecal sufentanil (457.02±75.76 vs 487.02±83.52 min, p<0.001). Bradycardia and hypotension were observed in 10.05% and 10.23%, respectively, and not modified by intrathecal sufentanil. Five cases of urinary retention and one case of transient neurologic symptom were recorded. Satisfaction of the patients was 8.51±1.87. Conclusions Intrathecal HP is efficient and side effects are rare. Sufentanil as an adjuvant is able to decrease the time of discharge.