Comparison Of Recovery Profile Of General Anaesthesia Versus Spinal Anaesthesia For Gynaecological Day Case Surgeries In Kenyatta National Hospital

Abstract

Background Day care surgery is gaining popularity with more and more procedures being performed on day care basis. Recovery is a key factor in the success of day care surgery with delayed recovery resulting in increased cost, reduced efficiency and unplanned admissions. Methods A total of ninety four patients were prospectively randomised to two groups; spinal anaesthesia and general anaesthesia. The spinal anaesthesia and general anaesthesia groups received anaesthesia as per protocol. They were monitored both intraoperatively and postoperatively at PACU. Vital signs, post operative complications, pain scores and time to achieve standardized discharge criteria were recorded in PACU. The incidence of unplanned admission was also recorded. Results The participants in the two groups were comparable with respect to age, ASA status, diagnosis and type of surgery. Participants in the spinal anaesthesia group took twice as long to achieve discharge criteria compared to those in general anaesthesia group. This was mainly due to longer time taken to achieve ambulation for the patients in the spinal anaesthesia group. The nausea and pain scores were similar. Only one patient in the spinal anaesthesia group was admitted for monitoring due to severe surgical bleeding. Conclusion Patients undergoing gynaecological surgery on day care basis under spinal anaesthesia with bupivacaine 7.5mg take longer to achieve standardized discharge criteria compared to those under general anaesthesia.