Selective spinal anaesthesia with low-dose bupivacaine and bupivacaine + fentanyl in ambulatory arthroscopic knee surgery. 2012

Demet Unal, and Levent Ozdogan, and Hatice Dilsen Ornek, and Hasan Karahan Sonmez, and Taner Ayderen, and Mahmut Arslan, and Bayazit Dikmen
Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey.

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.

UI MeSH Term Description Entries
D007592 Joint Diseases Diseases involving the JOINTS. Arthropathies,Arthropathy,Joint Disease
D007719 Knee Joint A synovial hinge connection formed between the bones of the FEMUR; TIBIA; and PATELLA. Superior Tibiofibular Joint,Joint, Knee,Joint, Superior Tibiofibular,Knee Joints,Superior Tibiofibular Joints,Tibiofibular Joint, Superior
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D005260 Female Females
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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