Spinal anaesthesia in day-case surgery: Optimizing the 'flow'

Datum: 11 december 2015

Locatie: Antwerp University Hospital (UZA) - Auditorium Kinsbergen (route 12) - Wilrijkstraat 10 - 2650 Edegem

Tijdstip: 16 uur

Organisatie / co-organisatie: Faculty of Medicine and Health Sciences

Promovendus: Margaretha Breebaart

Promotor: Prof M. Vercauteren & Prof S. De Wachter

Korte beschrijving: PhD defence Margaretha Breebaart - Faculty of Medicine and Health Sciences



Abstract

Day-case procedures require an anesthetic technique with the possibility of a high turnover, a high quality and low costs. Lidocaine is a local anaesthetic with a short duration of action and thus a very favorable profile for spinal anaesthesia in day-case surgery. However the risk of transient neurological symptoms (TNS) as a side effect appears to be higher after spinal lidocaine. Although this risk is lower with alternative local anaesthetics, their pharmacological profile is less suitable for day-case surgery.

Voiding is still a discharge criterion in many hospitals: faster voiding results in faster discharge. Urinary retention after spinal anesthesia is most often a result of prolonged sensory blockade of the pelvic nerves. This block is local anesthetic dose and potency dependent.

The goal of the different trials presented in this doctoral thesis is to optimize the time to void and discharge time after spinal anaesthesia for ambulatory surgery with a focus on bladder function. The several trials described compare different local anaesthetics with or without combining them with spinal additives. Further more the influence of a restrictive or non restrictive fluid policy on the time void and micturition problems is investigated. As a last part of this doctoral thesis, the comparison between different local anaesthetic techniques is made.