Plain articaine or prilocaine for spinal anaesthesia in day-case knee arthroscopy: a double-blind randomized trial.

BACKGROUND: Both prilocaine and articaine are short-acting local anaesthetics suited for spinal anaesthesia for day-case knee arthroscopy. Articaine is thought to have a faster onset and shorter duration of action than prilocaine, although no comparative study has been published in the anaesthetic literature. METHODS: In this prospective randomized double-blind study, spinal anaesthesia was performed in 72 ASA I-II patients undergoing knee arthroscopy with 50 mg of either plain prilocaine or plain articaine. The primary outcome variable was duration of motor block. Secondary outcomes were onset of sensory and motor blocks, maximum spread of the sensory block, time to spontaneous voiding, and side-effects. RESULTS: Time to full motor function recovery was shorter after articaine than prilocaine [mean (SD) 140 (33) vs 184 (46) min, respectively, P<0.001]. Time to spontaneous voiding was shorter after articaine than prilocaine [mean (SD) 184 (39) vs 227 (45) min, respectively, P<0.001]. One patient in the articaine group reported mild transient neurological symptoms (TNS) limited to the first postoperative day, but there were no significant differences in adverse effects between the groups. CONCLUSIONS: Spinal anaesthesia with plain articaine 50 mg resulted in a faster recovery of motor function and earlier spontaneous voiding compared with plain prilocaine 50 mg. Surgical anaesthesia was not different. The incidence of TNS was low.

[Subnormal vitamin B6 levels in theophylline users]. / Subnormale vitamine-B6-spiegels bij theofyllinegebruik.

OBJECTIVE: To study the effect of theophylline use on the vitamin B-6 status. DESIGN: Descriptive. SETTING: Department of Geriatric Medicine of Nijmegen Academic Hospital and Department of Pulmonary Diseases, University of Nijmegen, the Netherlands. PATIENTS AND METHODS: Vitamin B-6 status was determined by measuring pyridoxal-5'-phosphate (PLP) in whole blood (using a high performance liquid chromatography method, reference values: 35-107 mumol/l) in 141 patients from the Geriatric department (84 non-chronic obstructive pulmonary disease (COPD), 40 COPD patients without theophylline and 17 COPD patients with theophylline) and in 25 non-geriatric COPD patients on theophylline. RESULTS: Of the 84 geriatric non-COPD patients (mean age: 82 years; SD: 6) 56% had a subnormal vitamin B-6 status, of the 40 geriatric COPD patients without theophylline (82 years; SD: 6) 70%, of the 17 geriatric COPD patients on theophylline (80 years; SD: 5) 94% and of the 25 non-geriatric COPD patients on theophylline (62 years; SD: 11) 96%. CONCLUSION: In patients who used theophylline a higher prevalence of subnormal vitamin B-6 status was found than in patients who did not.