Intrathecal Injection of Hyperbaric Prilocaine Versus Hyperbaric Bupivacaine for Cystoscopic Procedures

Cystoscopy is a short surgical procedure in the field of urology that is very frequently performed. Spinal anesthesia (SA) is the choice because it has an easy implementation technique, fast onset, and low complications compared to general anesthesia.

One of the spinal anesthetic regimens often used is 0.5% hyperbaric bupivacaine, which has a two-segment regression time of around 65 minutes and requires 164 minutes for complete regression to the sacral dermatomes. However, bupivacaine, when used for relatively short procedures, causes various disadvantages including prolonged effects.

Prilocaine is an alternative to bupivacaine in short surgical procedures, including cystoscopy. It has a profile similar to lidocaine but with less neurotoxicity.

Inclusion criteria

• Age from 18 to 65 years.
• Both Sexes.
• American Society of Anesthesiologists (ASA) physical status I-II.
• Normal body mass index (BMI) 18-25.
• Undergoing cystoscopic procedure under spinal anesthesia.

Exclusion criteria

• - Patient's refusal.
• History of allergy to local anesthetics (hyperbaric prilocaine or hyperbaric bupivacaine).
• History of impaired gait before the study.
• Contraindications to SA including :-

• Coagulopathy.
• Elevated intracranial pressure (ICP).
• Infection at the site.
• Spinal cord disorder.
• Severe hypovolemia.
• Uncontrolled hypertension systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg.
• Uncontrolled Diabetes mellitus HbA1c ≥ 8.5%