title: Selective spinal anaesthesia with low-dose bupivacaine and bupivacaine + fentanyl in ambulatory arthroscopic knee surgery.
abstract: OBJECTIVE
  To investigate the effects of selective spinal anaesthesia with low-dose bupivacaine alone and in combination with various doses of fentanyl, on blockage, haemodynamics, quality of anaesthesia, perioperative complications, and hospital release criteria.
  
  
  METHODS
  This prospective study included 45 ASA I-II patients (age range: 20-77 years). The cases were randomised into 3 groups: Group 1 (n = 15) 0.8 ml of 4 mg 0.5% hyperbaric bupivacaine; Group 2 (n = 14) 1.3-ml solution of 4 mg 0.5% hyperbaric bupivacaine + 25 microg of fentanyl; and Group 3 (n = 14) 1.1-ml solution of 3 mg 0.5% hyperbaric bupivacaine + 25 microg of fentanyl. A double-blind design was employed and all patients were injected through L3-4 or L4-5 using a 25G point spinal needle. Sensory-motor blockage starting and ending time, maximum level of sensory-motor blockage, and grade and quality of anaesthesia were recorded. Haemodynamics, and respiration rates, and side effects were evaluated. Times for ability to pass to the stretcher without aid, walking, micturition, release from the hospital, and the first time an analgesic was needed were recorded.
  
  
  RESULTS
  The time when an analgesic was first required was longer in the groups in which an opioid was added, and the shortest release time from the hospital was observed in Group 3. Other parameters remained similar across all groups.
  
  
  CONCLUSIONS
  Low-dose bupivacaine, with or without fentanyl, can be used safely in lower extremity surgery and can provide rapid and safe release criteria.
authors: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors: Demet
authors: D
authors: Unal
authors: Levent
authors: L
authors: Ozdogan
authors: Hatice Dilsen
authors: HD
authors: Ornek
authors: Hasan Karahan
authors: HK
authors: Sonmez
authors: Taner
authors: T
authors: Ayderen
authors: Mahmut
authors: M
authors: Arslan
authors: Bayazit
authors: B
authors: Dikmen
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine