title: A comparison of selective spinal anesthesia with hyperbaric bupivacaine and general anesthesia with desflurane for outpatient knee arthroscopy.
abstract: In this randomized and controlled trial, 64 adult ambulatory knee arthroscopy patients received either selective spinal anesthesia (SSA) with 4 mg of hyperbaric bupivacaine or general anesthesia (GA) with desflurane. We conducted the study to determine whether SSA with small-dose bupivacaine provides equal fast-tracking possibilities, a shorter stay in the postanesthesia care unit, and earlier discharge home compared with GA with desflurane. Patients with a high risk for postoperative nausea and vomiting received prophylaxis in the GA group. No difference was seen in the fast-tracking possibilities or time in the postanesthesia care unit between the groups. Home readiness was achieved after 114 (31-174) and 129 (28-245) min (NS) in the SSA and GA groups, respectively. In the hospital, the pain scores were significantly (P < 0.001) lower in the SSA group compared with the GA group and the need for postoperative opioids was significantly (P = 0.008) larger after GA. The incidence of postoperative nausea and vomiting was 0% versus 19% in the SSA and GA groups (P = 0.024), respectively. We conclude that for outpatients undergoing knee arthroscopy, SSA with hyperbaric bupivacaine provides equal recovery times with less frequent side effects compared with GA with desflurane.
authors.affiliation: *Department of Anaesthesia, Lapland Central Hospital, Rovaniemi, Finland; †Department of Anaesthesia and Intensive Care, University of Helsinki, Helsinki, Finland.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Korhonen
authors.forename: Jukka V
authors.initials: JV
authors.lastname: Valanne
authors.forename: Ritva M
authors.initials: RM
authors.lastname: Jokela
authors.forename: Pirjo
authors.initials: P
authors.lastname: Ravaska
authors.forename: Kari T
authors.initials: KT
authors.lastname: Korttila
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D001182:Arthroscopy; D002045:Bupivacaine / Q000009:adverse effects; D000077335:Desflurane; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives*; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology
chemical_list: D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D000077335:Desflurane; D007530:Isoflurane; D002045:Bupivacaine