La rachianesthésie pour chirurgie ambulatoire : nouveaux enjeux et modalités de prise en charge des patients

Spinal anesthesia use is often debated for outpatient surgery, since the removal of lidocaine. This is related to the prolonged and unpredictable sensory blockade despite low doses of long acting local anesthetics such as bupivacaine, delaying discharge of patients. Although the intermediate sensory blockade duration of mepivacaine seems to be more suitable for outpatient surgery, its use is not recommended due to a high incidence of transient neurological symptoms. Prilocaine has a similar pharmacodynamic profile to lidocaine, with a significantly lower risk of neurological disorders. The 2-chloroprocaine has a shorter duration of action compared to lidocaine or prilocaine. This review highlights recent outpatient management, clinical use of spinal anesthesia and local anesthetics that can offer real alternatives to general anesthesia or peripheral nerve blocks for ambulatory surgery.