Subarachnoid sufentanil versus lidocaine spinal anesthesia for extracorporeal shock wave lithotripsy

Abstract

Background and objectives: Anesthetic techniques that reduce the time required for postoperative care can significantly reduce the cost of procedures. This study was designed to discover whether the use of subarachnoid sufentanil for extracorporeal shock wave lithotripsy (ESWL) would enable patients to be discharged more rapidly following surgery as compared with subarachnoid lidocaine, while providing equivalent efficacy.

Methods: Thirty-nine patients undergoing 40 ESWLs were randomized to receive either 12.5 microg of sufentanil or 75 mg of lidocaine by the subarachnoid route. The need for additional analgesia, incidence of adverse effects, and time to discharge were recorded and compared.

Results: Patients receiving sufentanil were discharged 52 minutes sooner than patients receiving lidocaine (166 +/- 77 vs 218 +/- 46 minutes, respectively, P < .05). Analyzed separately, women receiving sufentanil were discharged earlier than those receiving lidocaine (120 +/- 55 vs 208 +/- 42 minutes, P < .01). There was no significant difference in discharge times between men in each group. Patients in the sufentanil group had more pruritus and less change in blood pressure than patients in the lidocaine group. There was no significant difference in the incidence of other adverse effects or in the use of additional analgesia or sedation.

Conclusions: Subarachnoid sufentanil provides acceptable analgesia for ESWL and offers the advantages of more rapid discharge for female patients and better hemodynamic stability as compared with lidocaine spinal anesthesia.