A comparison of selective spinal anesthesia with hyperbaric bupivacaine and general anesthesia with desflurane for outpatient knee arthroscopy.
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.
Korhonen
Anna-Maija
AM
*Department of Anaesthesia, Lapland Central Hospital, Rovaniemi, Finland; †Department of Anaesthesia and Intensive Care, University of Helsinki, Helsinki, Finland.
Valanne
Jukka V
JV
Jokela
Ritva M
RM
Ravaska
Pirjo
P
Korttila
Kari T
KT
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
D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D000077335:Desflurane; D007530:Isoflurane; D002045:Bupivacaine