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High Patient Satisfaction With Local Anesthesia and Light Sedation in a Novel Fast-Track Setup for Sacrospinous Fixation

Lydiksen, Henriette Arenholt, MD; Glavind-Kristensen, Marianne, PhD; Greisen, Susanne, PhD

Female Pelvic Medicine & Reconstructive Surgery: March 8, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000708
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Objectives Simple prolapse operations can be performed using local anesthesia. However, this has not been the case for advanced pelvic organ prolapse operations. The aim of this study was to investigate the patient-reported feasibility and acceptability of local anesthesia and light sedation for sacrospinous fixation (SSF).

Methods This is a prospective observational study on 105 women who underwent SSF in a public outpatient setting from April 2016 to October 2017. They received infiltration anesthesia with mepivacaine or lidocaine together with a pudendal nerve block with Marcaine. Local anesthesia was supplemented by intravenous light sedation and pain reliever. A Local Anesthetic Intraoperative Experience Questionnaire was used to evaluate patient experience.

Results One patient was converted to general anesthesia. Eighty-eight women answered the questionnaires. Ninety-nine percent defined themselves as satisfied or very satisfied with the anesthesia. Little or no pain during the operation was reported by 92% and 92% would choose the same type of anesthesia again. No adverse effect of the anesthetic procedure was observed. The median (range) admission time was 12 (4.5–48) hours, and 81% of the patients could be discharged on the day of surgery. At follow-up after 8 weeks and 6 months, no patients reported adverse events to the anesthesia.

Conclusions The SSF can be performed using local anesthesia and light sedation with high degree of patient satisfaction. These preliminary data indicate that the concept of ambulatory surgery might be implemented more widely if the use of local anesthesia is also applied to more advanced surgical procedures.

From the Aarhus University Hospital, Skejby, Denmark.

Correspondence: Henriette Arenholt Lydiksen, MD, Aarhus University Hospital, Skejby, Brendstrupgårdsvej 100, 8200 Aarhus N. E-mail: henriettelydiksen@live.dk.

The authors have declared they have no conflicts of interest.

H.A.L. did the data analysis and manuscript writing. M.G.K. did project development, data collection, data analysis, and manuscript editing. S.G. did project development, data collection, data analysis, and manuscript writing.

Presented at the Annual Danish Urogynecological Society Conference, May 01, 2018, Kolding, Denmark.

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