Spinal anesthesia for arthroscopic knee surgery.
OBJECTIVE
The purpose of the study was to compare the effects of adding 50 microg of morphine, 25 microg of fentanyl or saline to 6 mg of hyperbaric bupivacaine on postoperative analgesia and time to urination in patients undergoing arthroscopic knee surgery under spinal anesthesia.


METHODS
The study was designed in a prospective, randomized, double-blinded and placebo-controlled manner. Sixty ASA I-II patients were randomized into the following three groups: Group BM: 6 mg of bupivacaine and 50 microg of morphine, Group BF: 6 mg of bupivacaine and 25 microg of fentanyl, and Group BS: 6 mg of bupivacaine and saline. Selective spinal anesthesia was performed in a lateral decubitus position, with the operative knee dependent for 10 min.


RESULTS
In all groups satisfactory anesthesia was provided during the operation. There was a statistically significant difference between all the groups in times to voiding [Group BM 422 +/- 161 min; Group BF 244 +/- 163 min; Group BS 183 +/- 54 min (mean +/- SD)]. The incidence of pruritus was significantly greater in Group BM (80%) and BF (65%) in comparison with Group BS (no pruritus) (P < 0.05). The incidence of nausea was significantly increased in Group BM (35%) in comparison with Group BF (10%) and Group BS (P < 0.05). Analgesic consumption was significantly greater in Group BS in comparison with Groups BM and BF (P < 0.01).


CONCLUSIONS
We conclude that during spinal anesthesia even mini-dose intrathecal morphine is not acceptable for outpatient surgery due to side-effects, especially severely prolonged time to urination.
Gürkan
Y
Y
Department of Anesthesiology and Reanimation, Kocaeli University School of Medicine, Kocaeli, Turkey. yavuzg@superonline.com
Canatay
H
H
Ozdamar
D
D
Solak
M
M
Toker
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use / Q000652:urine; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use / Q000652:urine; D001182:Arthroscopy / Q000379:methods*; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use* / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use* / Q000652:urine; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use* / Q000652:urine; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced; D012965:Sodium Chloride / Q000008:administration & dosage / Q000009:adverse effects / Q000652:urine; D014554:Urination / Q000187:drug effects
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D012965:Sodium Chloride; D009020:Morphine; D005283:Fentanyl; D002045:Bupivacaine