Hyperbaric Prilocaine 2% Versus Hyperbaric Bupivacaine 0.5% for Spinal Anaesthesia in Children Undergoing Lower Abdominal Surgeries
Yousef, A., Amer, M., AL Sharaway, A., Hussein, H. (2025). Hyperbaric Prilocaine 2% Versus Hyperbaric Bupivacaine 0.5% for Spinal Anaesthesia in Children Undergoing Lower Abdominal Surgeries. EKB Journal Management System, 6(2), 45-62. doi: 10.21608/ejmr.2024.249002.1494
Ahmed Shaban Yousef; Mahmoud Moustafa Amer; Ahmed Mustafa AL Sharaway; Hazem Abdelwahab Hussein. "Hyperbaric Prilocaine 2% Versus Hyperbaric Bupivacaine 0.5% for Spinal Anaesthesia in Children Undergoing Lower Abdominal Surgeries". EKB Journal Management System, 6, 2, 2025, 45-62. doi: 10.21608/ejmr.2024.249002.1494
Yousef, A., Amer, M., AL Sharaway, A., Hussein, H. (2025). 'Hyperbaric Prilocaine 2% Versus Hyperbaric Bupivacaine 0.5% for Spinal Anaesthesia in Children Undergoing Lower Abdominal Surgeries', EKB Journal Management System, 6(2), pp. 45-62. doi: 10.21608/ejmr.2024.249002.1494
Yousef, A., Amer, M., AL Sharaway, A., Hussein, H. Hyperbaric Prilocaine 2% Versus Hyperbaric Bupivacaine 0.5% for Spinal Anaesthesia in Children Undergoing Lower Abdominal Surgeries. EKB Journal Management System, 2025; 6(2): 45-62. doi: 10.21608/ejmr.2024.249002.1494

Hyperbaric Prilocaine 2% Versus Hyperbaric Bupivacaine 0.5% for Spinal Anaesthesia in Children Undergoing Lower Abdominal Surgeries

Egyptian Journal of Medical Research
Volume 6, Issue 2, April 2025, Page 45-62  XML PDF (611.73 K)
Document Type: Original Article
DOI: 10.21608/ejmr.2024.249002.1494
View on SCiNiTO View on SCiNiTO
Authors
Ahmed Shaban Yousef email 1; Mahmoud Moustafa Amer2; Ahmed Mustafa AL Sharaway3; Hazem Abdelwahab Hussein4
1M.B.B.Ch, Faculty of Medicine, Beni-Suef University, Resident of Anesthesiology, Surgical Intensive Care and Pain Management ,Faculty of Medicine, Beni-Suef University
2Professor of Anesthesiology, Surgical Intensive Care and Pain Management, Faculty of Medicine, Beni-Suef University
3Assistant Professor of Anesthesiology, Surgical Intensive Care and Pain Management, Faculty of Medicine, Beni-Suef University
4Lecturer of Anesthesiology, Surgical Intensive Care and Pain Management, Faculty of Medicine, Beni-Suef University
Abstract
Background: Spinal anesthesia provides a secure and dependable anesthetic approach for children undergoing lower abdominal surgeries. A quick onset of motor and sensory block, predictable rate of regression and minimal incidence of side effects are all characteristics of the ideal spinal anesthetic agent. The aim of this study was to compare spinal anesthesia using hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% for children undergoing lower abdominal surgery. Methods: This study was conducted at Beni-Suef University Hospital on 50 patients. The patients were divided randomly into two equal groups; group A: received bupivacaine hydrochloride 0.5% and group B: received prilocaine Hydrochloride 2%. Demographic data, vital parameters, sensory‑motor block characteristics, and complications were noted. Results: Our study showed there was a highly significant difference regarding the block characteristics, where Prilocaine Group shows faster block onset time than Bupivacaine Group. Time to return to Bromage 0 was significantly shorter in Prilocaine Group than in Bupivacaine Group. Also; There was a significant longer recovery time, ambulation time and time of voiding of urine in the bupivacaine group than the prilocaine group. Conclusions: The present study shows that in children undergoing lower abdominal surgeries, Hyperbaric prilocaine provides faster onset time, shorter duration of action than bupivacaine. In addition, prilocaine showed less time for ambulation and voiding of urine with minimal side effects.
Keywords
Lower abdominal surgeries; Spinal anaesthesia; Prilocaine; Bupivacaine
References
  1. Bosenberg A. Benefits of regional anesthesia in children. Pediatric Anesthesia. 2012;22(1):10-18.
  2. Bhatia U, Abraham S, Panchal M, Parmar N, Khanbhaiwala FB, Gupta J. Intrathecal bupivacaine versus bupivacaine and clonidine in pediatrics: a double-blind controlled study. Ain - Shams Journal of Anesthesiology. 2022;14(1):103-109.
  3. Wu JP. Pediatric anesthesia concerns and management for orthopedic procedures. Pediatric Clinics. 2020;67(1):71-84.
  4. Whitaker EE, Wiemann BZ, DaJusta DG, Alpert SA, Ching CB, McLeod DJ, et al. Spinal anesthesia for pediatric urological surgery: reducing the theoretic neurotoxic effects of general anesthesia. Journal of pediatric urology. 2017 May 1;13(4):396-400.
  5. Akcaboy ZN, Akcaboy EY, Mutlu NM, Serger N, Aksu C, Gogus N. Spinal anesthesia with low-dose bupivacaine-fentanyl combination: a good alternative for day case transurethral resection of prostrate surgery in geriatric patients. Revista Brasileira de Anestesiologia. 2012 Apr;62(6):753-761.
  6. Wyles CC, Pagnano MW, Trousdale RT, et al. More Predictable Return of Motor Function with Mepivacaine Versus Bupivacaine Spinal Anesthetic in Total Hip and Total Knee Arthroplasty: A Double-Blinded, Randomized Clinical Trial. J Bone Joint Surg Am. 2020;102(18):1609-1615.
  7. Mohamed ES, Ragab AS, El-Din TN, Abdelattif AF, Elsaid MA. Prilocaine Fentanyl versus Bupivacaine-Fentanyl in Subarachnoid Anesthesia for Lower Abdominal Surgeries. The Scientific Journal of Medical Scholar. 2022 May 1;1(3):62-66.
  8. Vagts DA, Bley CH, Mutz CW. Use of 2% hyperbaric prilocaine for spinal anesthesia: sensitivity analysis in outpatient surgery. Der Anaesthesist. 2013 Apr;62(4):271-277.
  9. Aguirre J, Borgeat A, Bühler P, Mrdjen J, Hardmeier B, Bonvini JM. Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study. Canadian journal of anaesthesia= Journal canadien d'anesthesie. 2015 Oct;62(10):1055-62.
  10. Malinzak EB, Gan TJ. Regional anesthesia for vascular access surgery. Anesthesia & Analgesia. 2009 Sep 1;109(3):976-80.
  11. Lemoine A, Mazoit JX, Bonnet F. Modelling of the optimal bupivacaine dose for spinal anaesthesia in ambulatory surgery based on data from systematic review. European Journal of Anaesthesiology. 2016 Nov 1;33(11):846-52.
  12. Manassero A, Fanelli A. Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review. Local and regional anesthesia. 2017 Mar (31);10:15-24.
  13. Camponovo C, Fanelli A, Ghisi D, Cristina D, Fanelli G. A prospective, double-blinded, randomized, clinical trial comparing the efficacy of 40 mg and 60 mg hyperbaric 2% prilocaine versus 60 mg plain 2% prilocaine for intrathecal anesthesia in ambulatory surgery. Anesthesia & Analgesia. 2010 Aug 1;111(2):568-572.
  14. Talukder MRA, Mostafa MM, Chowdhury KA, Haque MF, Islam S, Mollah AM, et al. Spinal Anaesthesia in Paediatric Patients of District Level Hospital, Tangail, Bangladesh. 2021 Oct;3(5):96-101
  15. Gebhardt V, Kiefer K, Bussen D, Weiss C, Schmittner MD. Retrospective analysis of mepivacaine, prilocaine and chloroprocaine for low-dose spinal anaesthesia in outpatient perianal procedures. International Journal of Colorectal Disease. 2018 Oct;33(10):1469-1477.
  16. Etriki RG, Abd Ellatif HK, Sayouh EF, Mohammed AM. Spinal Anesthesia Using Hyperbaric Prilocaine 2% versus Hyperbaric Bupivacaine 0.5% for Day case Surgery. The Egyptian Journal of Hospital Medicine. 2022 Apr 1;87(1):1658-65.
  17. Abdalmegeed S, Mansour S, AbdelAzim R, Ibrahim Z. Comparative Study between Hyperbaric Bupivacaine 0.5% and Hyperbaric Prilocaine 2% in spinal anesthesia for Saddle Area Surgeries. Al-Azhar University Journal of Virus Researches and Studies. 2022;4(3):30-40.
  18. Verma D, Naithani U, Gokula C. Spinal anesthesia in infants and children: a one year prospective audit. Anesthesia, essays and researches. 2014;8(3):324.
  19. Chapron K, Sleth JC, Capdevila X, Bringuier S, Dadure C. Hyperbaric prilocaine vs. hyperbaric bupivacaine for spinal anaesthesia in women undergoing elective caesarean section: a comparative randomised double‐blind study. Anaesthesia. 2021 Jun;76(6):777-784.
  20. Ahmed M, Ali N, Kabir S, Nessa M. Spinal Anaesthesia: Is it Safe in Younger Children? Journal of Armed Forces Medical College, Bangladesh. 2010;6(1):25-38.
  21. Kaban OG, Yazicioglu D, Akkaya T, Sayin MM, Seker D, Gumus H. Spinal anaesthesia with hyperbaric prilocaine in day-case perianal surgery: randomised controlled trial. The Scientific World Journal. 2014 Jan 1;40(5):214.
  22. Goffard P, Leloup R, Vercruysse Y, Fils JF, Gautier PE, Kapessidou Y. Comparison of equipotent doses of intrathecal hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% for elective caesarean section: A prospective, randomised, controlled, two-centre clinical trial. European Journal of Anaesthesiology| EJA. 2022 Mar 1;39(3):227-235.
  23. Rehfuss A, Bogaert G, Kogan B. Spinal anesthesia in children: most pediatric urologists are not on board. Journal of pediatric urology. 2019;15(3):263.e1-. e5.
  24. Lönnqvist P-A. Spinal anaesthesia in children: A narrative review. Best Practice & Research Clinical Anaesthesiology. 2023;37(2):133-138.
  25. Bule SS, Sungandh RN, Irkhede KG, Sugandh SR. A study of spinal anaesthesia in paediatric patients of aged 2-8 years. J Med Sci Clin Res. 2017 Mar 1;5(3):19254-19259.
Statistics
Article View: 166
PDF Download: 71