Protocol
QUINCKE, DECUBITUS
After entering the operation room, patients underwent standard monitoring procedures, including assessments for percutaneous oxygen saturation and non-invasive blood pressure, as well as electrocardiography.In the GA group, a bolus injection of 1.5–2.0 mg/kg propofol and the target-controlled infusion of remifentanil with an effect-site concentration of 4.0 ng/mL were used for anaesthesia induction. After confirming the loss of consciousness, 0.6 mg/kg rocuronium was administered to facilitate insertion of a supraglottic airway device. After appropriate placement of the supraglottic airway device, a 20-gauge catheter was inserted into the radial artery to monitor invasive blood pressure continuously. Anaesthesia was maintained using sevoflurane and remifentanil. The depth of anaesthesia was monitored using the bispectral index (Medtronic, Ireland), with a target of 40–60 during the procedure.The effect-site concentration of remifentanil was increased up to 4–6 ng/mL to block autonomic nervous system responses 90 s before initiating bladder hydrodistention. If the mean blood pressure (MBP) dropped below 65 mmHg, the target effect-site concentration of remifentanil was lowered by 1 ng/mL.In the SA group, spinal anaesthesia was performed at the lateral decubitus position, using a 25-gauge Quincke needle under aseptic drapes. Considering the height of the patient, 12–14 mg of 0.5% bupivacaine was injected intrathecally. The accepted sensory block level was T10 or higher. Subsequently, radial artery catheterization was performed to monitor invasive blood pressure.In both groups, a rescue drug (ephedrine 5–10 mg, phenylephrine 20–50 µg) was administered if the MBP dropped below 65 mmHg, based on the decision of the attending anaesthesiologist. If the patient’s heart rate (HR) fell below 45 beats/min, 0.5 mg of atropine was injected intravenously. Midazolam or dexmedetomidine was administered intravenously if patients in the SA group required sedation.