[Subarachnoid anesthesia with minimal doses of lidocaine in ambulatory arthroscopic surgery of the knee].
The objective is demonstrate that subarachnoid anesthesia with 2% isobaric lidocaine at low doses (0.5 mg/kg) is safe and effective for outpatient arthroscopic surgery of the knee. This was a prospective study of 150 ASA I-III patients undergoing arthroscopic knee surgery as outpatients under subarachnoid anesthesia. With no prior vascular filling, we provided blockade by administering 2% isobaric lidocaine at a dose of 0.5 mg/kg through a Sprotte 25G needle without vasoconstrictor. We assessed effectiveness and degree of sensory-motor blockade, cardiovascular repercussions, recovery time (until reversal of blockade, ambulation, micturition and discharge) as well as side effects observed. The mean dose of lidocaine used was 33.44 +/- 4.16 mg. The sensory-motor blockade achieved provided optimum conditions for prevention of ischemia and the practice of the surgical procedure in all cases. Surgery lasted a mean 38 +/- 10 min. Hemodynamic changes were not clinically significant and no patients additional fluids, atropine or vasopressors. Time from start of blockade until ambulation, micturition and discharge from the recovery unit were 123 +/- 8.3, 175 +/- 12.4 and 194 +/- 13.4 min, respectively. Micturition was spontaneous in all cases. Complications recorded were cephalea and backache. In conclusion, subarachnoid anesthesia at low doses of 2% isobaric lidocaine provides excellent conditions for practicing arthroscopic surgery of the knee on outpatients, with minimum side effects.
Raich-Brufau
M
M
Servicio de Anestesiología y Reanimación, Hospital Universitario de Traumatología y Rehabilitación, Ciudad Sanitaria de la Vall d'Hebron, Barcelona.
Jiménez-Pérez
J A
JA
González-Carrasco
F J
FJ
Martínez-Ripol
P
P
Jornet-Balló
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000765:Anesthesia, Conduction / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013346:Subarachnoid Space
D000779:Anesthetics, Local; D008012:Lidocaine