title: Local or spinal anesthesia in acute knee surgery.
abstract: The aim of the study was to assess the efficacy, safety and complications of two anesthetic techniques including local and spinal anesthesia. A total of 436 patients received local (LA group = 250) or spinal (SA group = 186) anesthesia during a year period. SA group received 0.5% Bupivacaine 5 mg/mL. LA group received portal injection (5 mL lidocaine 2% with adrenaline) and intra-articular injection into the knee (10 mL lidocaine 2% with adrenaline). The following parameters were assessed: intraoperative pain (10 cm VAS: 0 = no pain, 10 = extreme pain), surgical operating conditions, patient satisfaction score (1 = very satisfied, 4 = very unsatisfied), postoperative analgesia, and time to discharge. In LA group, 97.6% (244/250) of patients experienced no pain throughout the procedure. Only six (2.4%) patients required conversion to general anesthesia. In SA group, two patients required conversion to general anesthesia. In both groups, 93.6% of patients were either satisfied or very satisfied with their anesthesia. The need ofpostoperative analgesics was higher in SA compared with LA group (p = 0.001). The mean postoperative stay was significantly shorter in LA than in SA group (p = 0.001). Ninety-four percent of LA and only 68% of SA patients were discharged from the hospital within 2 hours of the procedure. The rate of complications differed significantly between LA and SA groups (p = 0.037). Outpatient arthroscopy of the knee under local anesthesia is a simple, reliable, and safe alternative to spinal anesthesia, for patients in whom intraarticular disorders requiring diagnostic arthroscopy and arthroscopic surgery.
authors.affiliation: Department of Anesthesia and Intensive Care Unit, General Hospital Sveti Duh, Zagreb, Croatia. branka.maldini@zg.t-com.hr
authors.forename: Branka
authors.initials: B
authors.lastname: Maldini
authors.forename: Mladen
authors.initials: M
authors.lastname: Miskulin
authors.forename: Stanko
authors.initials: S
authors.lastname: Antolić
authors.forename: Tanja
authors.initials: T
authors.lastname: Goranović
authors.forename: Katarina
authors.initials: K
authors.lastname: Sakić-Zdravcević
authors.forename: Goran
authors.initials: G
authors.lastname: Gudelj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies