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Background <p>Varicose vein surgery is one of the most frequent indications for ambulatory vascular interventions. Although spinal anesthesia provides reliable surgical conditions, conventional intrathecal doses may delay mobilization and discharge due to prolonged block duration and hemodynamic instability. Unilateral spinal anesthesia with reduced local anesthetic doses has been proposed to facilitate early recovery. This study aimed to compare the perioperative block characteristics and recovery profiles of two different intrathecal bupivacaine doses in patients undergoing ambulatory varicose vein surgery.</p> Methods <p>In this prospective, randomized, double-blind trial, 80 adult patients scheduled for elective varicose vein surgery were allocated to receive either 4&#xa0;mg (Group I) or 6&#xa0;mg (Group II) of intrathecal hyperbaric bupivacaine. The primary endpoint was hospital discharge time. Secondary outcomes included the time from initiation to surgery, motor block positivity, motor block regression time, sensory block regression time, mobilization time, and advers effects.</p> Results <p>Seventy-four patients completed the study (Group I, <i>n</i> = 36; Group II, <i>n</i> = 38). Baseline demographic and clinical characteristics were comparable between groups. Median discharge time was significantly shorter in Group I compared with Group II (149 vs. 175.5&#xa0;min, <i>p</i> = 0.002). Similarly, sensory regression time (115 vs. 145.5&#xa0;min, <i>p</i> = 0.001) and mobilization time (132 vs. 157.5&#xa0;min, <i>p</i> = 0.001) were shorter in Group I. Motor block regression did not differ significantly between groups (<i>p</i> = 0.172). Higher thoracic sensory block levels were more frequent in Group II (<i>p</i> = 0.03). Hemodynamic parameters were comparable between the groups, except at the first postoperative hour, when heart rate was significantly lower in Group II (<i>p</i> = 0.001).</p> Conclusions <p>Unilateral spinal anesthesia with 4&#xa0;mg of hyperbaric bupivacaine provided effective surgical anesthesia for varicose vein surgery while significantly reducing discharge and mobilization times compared with 6&#xa0;mg. These findings support the use of lower intrathecal doses to enhance recovery and efficiency in ambulatory venous surgery.</p> Trial registration <p>ClinicalTrials.gov, NCT06527430 (Registered on 25 July 2024).</p>

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Different local anesthetic volumes for unilateral spinal anesthesia in varicose vein surgery prospective randomized clinical trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月10日

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  • Atakan Sezgi,
  • Musa Zengin,
  • Şeyma Hekimoğlu,
  • Mürüvvet Taşkır Turan,
  • İbrahim Topcu,
  • Emine Arık,
  • Elif Kılıç Çakmak,
  • Elif Şule Özdemir Sezgi,
  • Seyyid Furkan Kına,
  • Jülide Ergil

摘要

Background

Varicose vein surgery is one of the most frequent indications for ambulatory vascular interventions. Although spinal anesthesia provides reliable surgical conditions, conventional intrathecal doses may delay mobilization and discharge due to prolonged block duration and hemodynamic instability. Unilateral spinal anesthesia with reduced local anesthetic doses has been proposed to facilitate early recovery. This study aimed to compare the perioperative block characteristics and recovery profiles of two different intrathecal bupivacaine doses in patients undergoing ambulatory varicose vein surgery.

Methods

In this prospective, randomized, double-blind trial, 80 adult patients scheduled for elective varicose vein surgery were allocated to receive either 4 mg (Group I) or 6 mg (Group II) of intrathecal hyperbaric bupivacaine. The primary endpoint was hospital discharge time. Secondary outcomes included the time from initiation to surgery, motor block positivity, motor block regression time, sensory block regression time, mobilization time, and advers effects.

Results

Seventy-four patients completed the study (Group I, n = 36; Group II, n = 38). Baseline demographic and clinical characteristics were comparable between groups. Median discharge time was significantly shorter in Group I compared with Group II (149 vs. 175.5 min, p = 0.002). Similarly, sensory regression time (115 vs. 145.5 min, p = 0.001) and mobilization time (132 vs. 157.5 min, p = 0.001) were shorter in Group I. Motor block regression did not differ significantly between groups (p = 0.172). Higher thoracic sensory block levels were more frequent in Group II (p = 0.03). Hemodynamic parameters were comparable between the groups, except at the first postoperative hour, when heart rate was significantly lower in Group II (p = 0.001).

Conclusions

Unilateral spinal anesthesia with 4 mg of hyperbaric bupivacaine provided effective surgical anesthesia for varicose vein surgery while significantly reducing discharge and mobilization times compared with 6 mg. These findings support the use of lower intrathecal doses to enhance recovery and efficiency in ambulatory venous surgery.

Trial registration

ClinicalTrials.gov, NCT06527430 (Registered on 25 July 2024).