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Discharge times for knee arthroscopy in spinal vs. general anesthesia

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

Background

Spinal anesthesia (SPA) and general anesthesia (GA) are both safe techniques for knee arthroscopy. In this prospective, single-centre, randomised, clinical trial we compared the discharge times of SPA using 50mg hyperbaric prilocaine 2% and GA with propofol and sufentanil in patients undergoing ambulatory knee arthroscopy.

Methods

50 patients (18–80 years / American Society of Anaesthesiologists grade I–III) were randomized equally to receive either SPA or GA. The main outcome variable was the time until discharge from the day-surgery centre. Anesthesia related side effects, postoperative analgesics and patient satisfaction were assessed.

Results

Two of the spinal blocks failed and GA had to be provided. Despite of a faster recovery (unassisted ambulation: SPA: 90 (90–295)min vs. GA: 156 (93–235)min, p=0.0029), spontaneous voiding led to a delayed discharge in the SPA group (SPA: 240 (135–295)min vs. GA: 156 (93–235)min, p<0.0001). There were no differences between the groups regarding other anesthesia related side effects, postoperative demand of analgesics or patient satisfaction.

Conclusion

SPA with 50mg hyperbaric prilocaine 2% leads to a later discharge than GA with sufentanil and propofol. However, a reevaluation of existing discharge recommendations including obligatory micturition is necessary, to make SPA become even more advantageous for ambulatory surgery.

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Authors and Affiliations

  1. Department of Anesthesiology and Surgical Intensive Care Medicine, University Medical Centre Mannheim, 68167, Mannheim, Germany

    Volker Gebhardt, Marcel Monnard & Marc D. Schmittner

  2. Department of Medical Statistics, University Medical Centre Mannheim, 68167, Mannheim, Germany

    Christel Weiss

Authors
  1. Volker Gebhardt
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  2. Marcel Monnard
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  3. Christel Weiss
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  4. Marc D. Schmittner
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Correspondence to Marc D. Schmittner.

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Gebhardt, V., Monnard, M., Weiss, C. et al. Discharge times for knee arthroscopy in spinal vs. general anesthesia. cent.eur.j.med 9, 446–454 (2014). https://doi.org/10.2478/s11536-013-0303-1

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  • DOI: https://doi.org/10.2478/s11536-013-0303-1

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