A retrospective evaluation of the use of isobaric and hyperbaric bupivacaine in spinal anesthesia for varicose vein surgery

Objective: This study aimed to retrospectively evaluate the effects of hyperbaric (heavy) and isobaric bupivacaine used in spinal anesthesia for patients undergoing varicose vein surgery, in order to determine the more appropriate anesthetic agent. Materials and Methods: The study included 32 patients who received hyperbaric bupivacaine (Group H) and 33 patients who received isobaric bupivacaine (Group P). Group H received 2.5 mL of 0.5% hyperbaric bupivacaine, while Group P received 2.5 mL of 0.5% isobaric bupivacaine. Data regarding the characteristics of the block and hospital length of stay were obtained from patient records. Intraoperative and postoperative data, including Visual Analog Scale (VAS) scores, vital signs, Richmond Agitation and Sedation Scale (RASS) scores, and complications, were retrospectively reviewed and recorded. Results: Compared with Group P, Group H demonstrated significantly shorter hospital stays, block regression times, and sensory and motor block onset times (p<0.05). Additionally, the dermatomal level of the block was significantly higher in Group H than in Group P (p<0.05). There were no statistically significant differences between the two groups in terms of VAS scores, vital parameters, RASS scores, duration of surgery, surgical or patient comfort, intraoperative inotrope (ephedrine) and analgesic requirements, or intraoperative and postoperative complications (p>0.05). Discussion and Conclusion: Both isobaric and hyperbaric bupivacaine provided safe and adequate anesthesia in patients undergoing varicose vein surgery under spinal anesthesia. Since patients receiving hyperbaric bupivacaine exhibited shorter sensory and motor block onset and regression times, as well as earlier discharge, this agent may offer an advantage in terms of cost efficiency. Therefore, considering hospital-related costs, hyperbaric bupivacaine may be preferred in such cases. Keywords: Spinal Anesthesia, Isobaric Bupivacaine, Hyperbaric Bupivacaine, Varicose Vein Surgery