Abstract
Spinal anesthesia is an increasingly popular technique for ambulatory anesthesia. Desires for increased efficiency have driven our practice to seek spinal anesthesia that provides adequate anesthesia with the briefest possible recovery period. Use of small doses of spinal lidocaine and bupivacaine are appropriate in the outpatient setting in order to decrease patient recovery time. Unfortunately, use of small doses of local anesthetics are associated with a potentially high anesthetic failure rate. Addition of spinal adjuncts such as epinephrine and fentanyl can improve anesthetic success of small dose spinal anesthesia. Addition of epinephrine is not recommened due to prolongation of patient recovery, whereas addition of small doses of fentanyl appear to enhance surgical anesthesia without prolonging patient recovery
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