Quality of Recovery (QoR-15), Readiness of Discharge, Saddle Block Anesthesia
Conditions
Brief summary
Most minor perianal surgeries are performed as day-case procedures requiring rapid recovery and effective symptom control. Saddle block anesthesia (SBA) provides reliable perineal anesthesia with minimal hemodynamic and motor effects, promoting faster recovery than general anesthesia. However, the duration of sitting after intrathecal injection influences anesthetic spread, and the optimal sitting time to balance adequate anesthesia with early discharge remains unclear.
Detailed description
Spinal anesthesia will be administered in the sitting position at the L4-5 interspinous space using 7.5 mg of 0.5% hyperbaric bupivacaine. Hemodynamic data (heart rate and blood pressure) will be recorded at baseline, then at 2 min interval after SBA until the end of surgery. Postoperative pain will be assessed using the numeric rating scale at the post anesthesia care unit (PACU) and before discharge. If the numeric rating scale (NRS) \> 3 or at any time if demanded by the patient, 15 mg of IV ketorolac will be given if persisted titrated doses of nalbuphine will be given In case of postoperative nausea and vomiting, 4 mg of IV ondansetron will be given.
Interventions
OTHER5-min sitting duration after SBA
Patients will remain seated for 5 min after local anesthetic injection
OTHER8-min sitting duration after SBA
Patients will remain seated for 8 min after local anesthetic injection
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients (21-65 years), ASA I-III undergoing perianal surgery.
Exclusion criteria
* Severe cardiac morbidities (impaired contractility with ejection fraction \< 40%, heart block, arrhythmias, tight valvular lesions) * Contraindication to neuraxial anesthesia such as coagulopathy and local infection * Pregnant or lactating women, * Allergy of any of the study drugs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to readiness for discharge | During the first 24 hour postoperatively | Patients will be considered ready for discharge when the modified Post Anaesthetic Discharge Scoring System (PADSS) \>9 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| time to void | from SBA till 24 hour postoperatively | time in min until patient able to urinate |
| time to ambulation | from SBA till 24 hour postoperatively | time in min from SBA until patient able to move independently |
| quality of recovery | at the end of 24 hour after surgery | using QOR-15 score; 15-item questionnaire designed to assess a patient's quality of recovery following surgery and anesthesia It measures recovery across five key domains: physical comfort, pain, physical independence, psychological support, and emotional state. Scoring Range: Each of the 15 questions is rated on an 11-point scale (0-10). The total score ranges from 0 (extremely poor recovery) to 150 (excellent recovery). |
Countries
Egypt
Outcome results
None listed