الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The introduction of new anaesthetic procedures, the innovation of safe monitoring equipment and the existence of a lot of anaesthetic drugs have made ambulatory surgery flourishing. Disease status and length of the procedure are no more obstacles for ambulatory surgery. Cost reduction is really the most encouraging factor for expanding this type of clinical sittings.
In our center, spinal anaesthesia is frequently conducted for urological procedures. After carrying out a pilot study, a dose of 5 mg bupivacaine in hypobaric solution 0.1 % was found to produce sufficient analgesia and adequate sensory block for cystoscopic procedures. We can describe it as safe, simple technique, with a relatively quick onset of action, with good intraoperative conditions and with minimal postoperative side effects. The addition of fentanyl to local anaesthetic leaves a residual postoperative analgesia as well. These factors, to some extent, may gather to describe an ”ideal outpatient anaesthetic”.
Spinal anaesthesia might be a useful technique for ambulatory surgery.
Hypotension severe enough to be rectified with vasopressor occurs frequently with the use of hyperbaric local anaesthetic solutions(IOS, 106). In our study, hypotension requiring ephedrine treatment occurred very infrequently; 5% and 7.5% in B and BF group respectively. This stable blood pressure has eliminated the need for large volumes of fluid infusion and consequently will decrease the likelihood of bladder distension; a frequent side effect in ambulatory anaesthesia sittings.
The feared complications of spinal anaesthesia especially PDPH and backache are still limiting its use. In this study PDPH was a complaint in less than 5% of patients, which is recognizably less than other studies (69, 70). The use of small gauge needles, the non-cutting technique’J?” and the ease of administratio~ by trained anaesthetist have made PDPH and backache..lower. It is worth mentioning that the incidence of backache after spinal anaesthesia has been reported to vary from 2% to 25%(108,109). The exact aetiology is unknown but cutting the ligaments during trials of spinal anaesthesia may be a contributing factor. This of course does not explain backache after general anaesthesia.