Plain articaine or prilocaine for spinal anaesthesia in day-case knee arthroscopy: a double-blind randomized trial.
BACKGROUND
Both prilocaine and articaine are short-acting local anaesthetics suited for spinal anaesthesia for day-case knee arthroscopy. Articaine is thought to have a faster onset and shorter duration of action than prilocaine, although no comparative study has been published in the anaesthetic literature.


METHODS
In this prospective randomized double-blind study, spinal anaesthesia was performed in 72 ASA I-II patients undergoing knee arthroscopy with 50 mg of either plain prilocaine or plain articaine. The primary outcome variable was duration of motor block. Secondary outcomes were onset of sensory and motor blocks, maximum spread of the sensory block, time to spontaneous voiding, and side-effects.


RESULTS
Time to full motor function recovery was shorter after articaine than prilocaine [mean (SD) 140 (33) vs 184 (46) min, respectively, P<0.001]. Time to spontaneous voiding was shorter after articaine than prilocaine [mean (SD) 184 (39) vs 227 (45) min, respectively, P<0.001]. One patient in the articaine group reported mild transient neurological symptoms (TNS) limited to the first postoperative day, but there were no significant differences in adverse effects between the groups.


CONCLUSIONS
Spinal anaesthesia with plain articaine 50 mg resulted in a faster recovery of motor function and earlier spontaneous voiding compared with plain prilocaine 50 mg. Surgical anaesthesia was not different. The incidence of TNS was low.
Hendriks
M P
MP
Department of Anesthesiology, Canisius Wilhelmina Hospital, PO Box 9015, 6500 GS Nijmegen, The Netherlands.
de Weert
C J M
CJ
Snoeck
M M J
MM
Hu
H P
HP
Pluim
M A L
MA
Gielen
M J M
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods; D000762:Anesthesia Recovery Period; D000772:Anesthesia, Local / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D001182:Arthroscopy / Q000379:methods*; D002355:Carticaine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012677:Sensation / Q000187:drug effects; D013997:Time Factors; D014554:Urination / Q000187:drug effects; D055815:Young Adult
D000779:Anesthetics, Local; D011318:Prilocaine; D002355:Carticaine