Patients’ satisfaction with sedoanalgesia versus subarachnoid analgesia in endourology

Abotaleb, Usama I.; Amer, Gamal F.M.; Metwally, Osama S.; Hegazy, Abd Al-Azeem A.; Elsaid, Ahmad M.

doi:10.1016/j.egja.2011.06.005

Patients’ satisfaction with sedoanalgesia versus subarachnoid analgesia in endourology

Authors

10.1016/j.egja.2011.06.005

Abstract

Objective
In this study the effectiveness and safety of sedoanalgesia technique compared to spinal anesthesia in endourology procedure as well as patients’ satisfaction was assessed.
Patients and methods
A prospective randomized study was performed in 80 adult patients, ASA I, II, and III who underwent various endoscopic procedures randomly allocated into two groups 40 patients each: Sedoanalgesia group, received local anesthesia (2% lignocaine gel), i.v. midazolam incremental doses 0.015 mg/kg on demand, and i.v. fentanyl 2 μg/kg, and 0.5 μg/kg on demand interaoperative, and Spinal anesthesia group received 2.5 ml heavy bupivacaine 0.5% to achieve around T10 level. We recorded vital parameters, and the number of cases with hemodynamic, respiratory complications, nausea and vomiting, and conversion to general anesthesia (failure). Postoperatively the intensity of pain (VAS 0-100 mm), time to first analgesic request (VAS ⩾30), patient satisfaction (complete, partial or not satisfied) and time to readiness for discharge were assessed.
Results
There was no significant difference in intra, postoperative hemodynamic changes and complications between groups but hypotension was more frequent in Spinal group. Immediate postoperative, there was no significant difference in pain score between groups, but 1 and 2 h postoperatively there were higher pain scores in Sedoanalgesia group. Time to first analgesic request and readiness for discharge were significantly less in Sedoanalgesia group, but the difference was not significant as regard satisfaction scores.
Conclusion
Sedoanalgesia is an effective, safe and simple alternative to Spinal anesthesia for endourology, with good patients’ satisfaction and less time to discharge.

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