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Background and Aims Prilocaine, an amide-type local anesthetic, is known for its fast onset and intermediate duration of action. This retrospective analysis compares the duration of spinal anesthesia with prilocaine and ropivacaine in patients undergoing transurethral removal of bladder tumors (TURBT).

Methods Thirty patients scheduled for TURBT were divided into two groups: one receiving ropivacaine 7,5% (n=15) and the other prilocaine 5% (n=15). The primary hypothesis was that patients receiving prilocaine would have shorter duration of sensory and motor blockade and thus would bypass post-anesthesia care unit (PACU). Secondary outcomes included recovery, hemodynamic and immediate postoperative complications.

Results Both groups were similar in terms of demographic characteristics (Age, BMI, Gender), ASA classification and duration of surgery (GroupPrilocaine=36.7±13.8, GroupRopivacaine=43.8±24.4, p=0.337). The duration of sensory and motor blockade was found to be statistically significant less in patients receiving prilocaine, compared to the patients receiving ropivacaine (GroupPrilocaine= 38.3±17.8, GroupRopivacaine=61.3±33.1, p=0.025). Additionally, patients in the prilocaine group had shorter PACU duration and less mean arterial pressure drop after the performance of spinal anesthesia, when compared to the ropivacaine group patients (GroupPrilocaine= 14.7±4.11, GroupRopivacaine=22.9±6.70, p<0.001). No complications were reported.

Conclusions Prilocaine, compared to ropivacaine, contributes to a shorter duration of motor and sensory blockade, leading to a faster recovery in patients undergoing transurethral bladder tumor removal, while offering hemodynamic stability. This study suggests that prilocaine administered in spinal anesthesia for patients undergoing TURBT, may offer advantages over ropivacaine, potentially improving perioperative management and patient outcomes.