This study aims to compare effect of adding fentanyl or dexmetomidine on duration of motor and sensory block after spinal anesthesia with prilocaine during day case perianal surgery and whether it impact time to discharge home.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
159
A peripheral intravenous (IV) catheter will be inserted, and a 7 mL kg-1 crystalloid infusion will be initiated. The patients will be premedicated with 0.03 mg kg-1 midazolam IV. Heart rate and peripheral oxygen saturation (SpO2) will be monitored continuously; systolic, diastolic, and mean arterial pressure (MAP) will be measured noninvasively at 5 min intervals during the procedure and at 15 min intervals during the post anesthesia care unit (PACU) stay. The baseline values will be recorded. Nasal oxygen 2 L min-1 will be administered during the whole procedure
Faculty of Medicine Ain Shams University
Cairo, Egypt
Sensory block resolution to S3 block
The sensory block will be measured at the midclavicular line with a pinprick test (via a 22 gauge hypodermic needle)
Time frame: at 1 min intervals until the maximum block will be achieved and at 15 min intervals thereafter until the block resolved to S3 dermatome.
Home discharge
(modified Alderts score) ≥9, able to void spontaneously and the sensory block resolves to the S3 dermatome.
Time frame: Home discharge will be assessed as the time from the end of surgery until the patients reach a post-anesthesia discharge score
incidence of postoperative urinary retention (POUR)
The postoperative urinary retention (POUR) will be evaluated at hourly intervals in the PACU and ward; ultrasonic bladder scanning will be used for this purpose. If the bladder volume exceeds 500 mL and the patient has not voided spontaneously, urinary catheterization will be introduced.
Time frame: within 6 hours after surgery
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