Randomised comparison of hyperbaric articaine and hyperbaric low-dose bupivacaine along with fentanyl in spinal anaesthesia for day-case inguinal herniorrhaphy.

Background and objective Low-dose mixture of hyperbaric bupivacaine and fentanyl is commonly used in day-case spinal anaesthesia. Using hyperbaric articaine, the onset may be faster and duration more predictable than with bupivacaine–fentanyl. We compared these two spinal anaesthetics for inguinal herniorrhaphy. Methods Adult patients were randomised to spinal anaesthesia with hyperbaric articaine 84 mg (group A, n = 40) or hyperbaric bupivacaine 7 mg along with fentanyl 10 μg (group B+F, n = 40). A blinded observer tested the block characteristics. Aiming at sensory block spread to T10 dermatome, the operating table was tilted head-end up or down 10° (once or twice), as required. Postoperative telephone interviews were performed. Results All patients in group A had a sensory block to T10 in a median time of 4 (range 2–20) min. In group B+F, the median onset time of T10 analgesia was 10 (2–30) min (P  Conclusion Hyperbaric articaine leads to faster onset of block and faster recovery than bupivacaine along with fentanyl. Hypotension is more common with articaine. The onset and extension of the spinal block are unpredictable when using these techniques.