Efficacy of intravenous lipid emulsion in enhancing the recovery of spinal anesthesia: An exploratory double-blinded, randomized controlled study

Purpose:

Prolonged motor recovery associated with spinal anesthesia (SA) limits its utility in day-case surgery. We evaluated the efficacy of intravenous lipid emulsion (ILE) in accelerating recovery from sensory-motor blockade in patients undergoing day-case surgery under SA.

Methods:

In a double-blinded randomized study, 60 adult patients who underwent short surgical procedures under SA were randomly allocated to receive either ILE (1.5 mL/kg bolus, followed by 0.25 mL/kg/min infusion) over 30 minutes (test group) or normal saline (control group) in the immediate postoperative period. The primary objective was the time to recovery of sensory and motor blockade. The study was registered in the clinical trial registry of India CTRI/2021/11/038080 dated 11/6/2021 (www.ctri.nic.in).

Results:

Demographic characteristics (age, gender, American Society of Anaesthesiologists physical status grading, height, and weight) were comparable between the two groups. The recovery of sensory (200.6 ± 19.8 min versus 237.1 ± 17.9 min, P ≤ 0.001, absolute standard difference: -−1.9 (95% confidence interval [CI]: -−2.5 to -−1.3) and motor block (157.8 ± 13.1 min versus 193.6 ± 23.0 min, P ≤ 0.001, absolute standard difference: -−1.9 (95% CI: -−2.5 to -−1.3) were significantly faster in the test group compared to the control group.

Conclusions:

This study demonstrates that 20% ILE accelerates recovery from SA (both sensory and motor blocks), highlighting its potential utility in day-case surgery. Further trials on a larger sample size are required to validate the same.

Trial Registration: CTRI/2021/11/038080 dated 11/6/2021.