Local or spinal anesthesia in acute knee surgery

Scientific paper - Original scientific paper

• Title (croatian): Bol pri kirurškoj artroskopiji koljena kod lokalne versus spinalne anestezije
• Author: Branka Maldini
• Author: Mladen Miškulin
• Author: Stanko Antolić
• Author: Tanja Goranović
• Author: Katarina Šakić-Zdravčević
• Author: Goran Gudelj
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

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 of postoperative 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.

Abstract (croatian)

Cilj istraživanja u prikazanoj studiji bio je ispitati učinkovitost, sigurnost i komplikacije dviju anestezioloških tehnika koje uključuju lokalnu i spinalnu anesteziju. Ukupan broj ispitivanih bolesnika je bio 436, kada je lokalna (LA grupa=250) ili spinalna (SA grupa=86) anestezija ordinirana tijekom godine dana. SA grupi ordiniran je 05% levobupivacain 5mg/mL. LA grupa primila je portalnu injekciju (5 mL lidokaina 2% sa adrenalinom) i intra-artikularnu injekciju u koljeno (10 mL lidocaina sa adrenalinom). Sljedeći parametri su praćeni: intraoperacijska bol (10 cm VAS: 0=nema boli, 10=neizdrživa bol), kirurški operacijski uvijeti, bolesnikovo zadovoljstvo (1=jako zadovoljan, 4=jako nezadovoljan), postoperacijska analgezija, te vrijeme napuštanja bolnice. U LA grupi, 97,6% (244/250) nije imalo boli za vrijeme operacijskog zahvata. Samo šest bolesnika, (2,4%) je zahtjevalo konverziju u opću anesteziju. U SA grupi, dva bolesnika su zahtjevala konverziju u opću anesteziju. U obje grupe, 93,6% bolesnika je bilo zadovoljno ili jako zadovoljno sa primjenjenom anestezijom. Potreba za postoperacijskom analgezijom bila je veća u LA u usporedbi sa SA grupom (p=0,001). Srednji postoperacijski ostanak je značajno bio kraći u LA nego u SA grupi (p=0,001). Devedesetičetiri bolesnika sa LA i samo 68% od SA su napustili bolnicu unutar 2 sata nakon zahvata (p=0,001). Učestalost komplikacija se značajno razlikovala između LA i SA grupe (p<0,037). Ambulantna artroskopija koljena učinjena u lokalnoj anesteziji je jednostavna, pouzdana i sigurna alternativa spinalnoj anesteziji, za bolesnike u kojih intraartikilacijski poremećaji zahtjevaju dijagnostičku ili artroskopsku kirurgiju.

• Keywords (english): Adolescent; Adult; Aged; Anesthesia, Local/adverse effects; Anesthesia, Spinal/adverse effects; Arthroscopy; Female; Humans; Knee/surgery; Male; Middle Aged; Pain, Postoperative/drug therapy; Prospective Studies
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 34, no. S. 1, pp. 247-54
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:703851
• Publication: 2010-03
• Document URL: https://hrcak.srce.hr/51773
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 11:44:53