Perioperative complications in patients undergoing urological surgery with spinal anesthesia: A prospective, observational study

Background: Spinal anesthesia is widely used as the primary anesthesia method in urological surgeries, and this prospective observational study aimed to evaluate the associated complications.Materials and Method: Demographic data, procedures, and spinal anesthesia-related complications (e.g., hypotension, bradycardia, and headache) of patients who underwent urological surgery with spinal anesthesia were recorded perioperatively. Patients were questioned about complications on the 5th and 14th postoperative days.Results: Mean arterial pressure decreases in those administered intraoperative hyperbaric bupivacaine were higher at the 5th (p=0.010), 10th (p=0.003), and 15th minute (p=0.001) than in those administered levobupivacaine and lidocaine. In patients administered crystalloid and colloid solutions, an increase in hypotension was observed at the intraoperative 10th minute (systolic arterial pressure (SAP): p=0.008, diastolic arterial pressure (DAP): p=0.011) and 15th minute (SAP: p=0.017). Post-dural puncture headache (PDPH) occurred on days 1 and 2 in 7 patients and resolved within 3 days. Two patients reported leg pain and one patient reported gluteal numbness with bupivacaine. A majority of the patients (83%) stated that they would prefer spinal anesthesia if they were to have surgery again.Conclusions: Identifying perioperative complications in urological surgeries performed under spinal anesthesia helps in effective management and has implications for clinical practice.