Intrathecal hyperbaric bupivacaine 3 mg + fentanyl 10 microg for outpatient knee arthroscopy with tourniquet.
Acta Anaesthesiol Scand
; 47(3): 342-6, 2003 Mar.
Article
em En
| MEDLINE
| ID: mdl-12648202
ABSTRACT
BACKGROUND:
Combination of local anesthetic and opioid enables the use of less spinal anesthetic and increases the success of anesthesia. Intrathecal opioid does not prolong motor recovery and thus should not delay discharge home. We hypothesized that 3 mg of hyperbaric bupivacaine with 10 microg of fentanyl permits fast-tracking or shorter stay in post anesthesia care unit (PACU), and earlier discharge home, compared with 4 mg of hyperbaric bupivacaine.METHODS:
In this double-blind study, 100 outpatients undergoing knee arthroscopy received randomly either 4 mg of bupivacaine (B4) or 3 mg of bupivacaine + 10 microg fentanyl (B3F) intrathecally. The volume of 0.8 ml was injected at the L2/3 interspace over a 2-min period. A lateral decubitus position was maintained for 10 min. The sensory block was recorded by using thermal stimuli, and motor block was assessed according to a modified Bromage scale. Fast-tracking criteria were complete recovery of motor block, sensory block Th12 or lower and stable vital signs.RESULTS:
One block (1%) failed. Motor recovery was faster in the B3F group 60% of the patients recovered in 80 min or less compared with 28% in group B4 (P = 0.002). The PACU-time was shorter 36 (10-103) vs. 55 (10-140) min, respectively (P = 0.005). Seventeen (B3F) vs. nine patients (B4) could bypass PACU (NS). Time to discharge home was similar in both groups. In the B3F group, 75% of the patients developed pruritus.CONCLUSION:
Both solutions produced reliable spinal anesthesia for outpatient knee arthroscopy. The PACU-time was shorter in the bupivacaine-fentanyl group, but both groups reached home-readiness equally.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artroscopia
/
Bupivacaína
/
Fentanila
/
Anestésicos Intravenosos
/
Procedimentos Cirúrgicos Ambulatórios
/
Analgésicos Opioides
/
Raquianestesia
/
Joelho
/
Anestésicos Locais
Tipo de estudo:
Clinical_trials
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Acta Anaesthesiol Scand
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Finlândia