New Anesthesia Procedure during Tvt Surgery: Motor Nerve Preservation with Spinal Anesthesia Using Low-dose Bupivacaine

Aims of Study In the case of tension-free vaginal tape (TVT) surgery, muscle strength is required for obtaining an adequate increase in abdominal pressure when conducting a stress test by coughing during the procedure. Consequently, although the procedure is frequently performed under local infiltration anesthesia, this requires the use of a large amount of local anesthetic. We employ the use of spinal anesthesia using a low dose of bupivacaine that allows the obtaining of reliable analgesic effects while minimizing motor blocking. When lowdose bupivacaine at a concentration of one-half to one-fourth the normal dose is used for spinal anesthesia, motor blocking has been reported to be only mild despite adequate sensory blocking, indicating dissociation between sensory and motor anesthetic depth. This study was conducted for the purpose of assessing the usefulness of this new anesthesia technique in its application to TVT surgery.