A Prospective Randomized Comparison of Spinal Versus Local Anesthesia With Propofol Infusion for Knee Arthroscopy

Spinal anesthesia for knee arthroscopy is a well-documented and safe procedure. However, some complications and higher costs have been reported. Also, many orthopaedic surgeons are reluctant to use local anesthesia for fear of having to convert to general anesthesia due to inadequate pain control. The purpose of this study is to compare local with spinal anesthesia in two groups of patients submitted to knee arthroscopy. Sixty-five patients were divided in two groups; based on the anesthesia method used, and submitted to the same surgical routine and postoperative analgesia protocol. They were evaluated for analgesia, level of postoperative pain, and level of satisfaction with the type of anesthetic. The two groups did not present any significant differences in relation to perioperative analgesia and pain on the first postoperative day, neither was there any difference in relation to emotional state. However, there was a significant difference in terms of acceptance of the procedure; 100% said they would accept the procedure again in the local anesthesia group, compared with 60.5% in the spinal anesthesia group; also, 100% in the local anesthesia group said they felt encouraged by the type of anesthesia, compared with 67.7% in the spinal anesthesia group. We can conclude that local anesthesia is similar to spinal anesthesia in almost all the aspects investigated, except in terms of acceptance and patients’ level of satisfaction with the procedure. Local anesthesia can be a good alternative to spinal anesthesia, especially in outpatient departments, or when patients have restrictions to traditional models of anesthesia.

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Section: Discussionsupporting

confidence: 93%

Comparative Study of Spinal and Local Anesthesia With Propofol Infusion for Knee Arthroscopy

Silva

Matos

Madureira

et al. 2012

Revista Brasileira de Ortopedia (English Edition)

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“…Our study demonstrated that the amount of pain at this time was similar in the two groups, without any statistical difference, thus showing that the efficacy of postoperative analgesia with local anesthesia using propofol is equivalent to analgesia achieved through spinal block. These findings are compatible with those of Ben-David et al (10) , Jacobson (1) and Dunn (13) . However, Jacobson found a significant difference such that a smaller number of patients used analgesics in the group that underwent local anesthesia, compared with the group that underwent spinal anesthesia.…”

Section: Discussionsupporting

confidence: 83%

“…The results found in the present study have also been observed in other similar studies. In a randomized prospective clinical study comparing spinal anesthesia and local anesthesia using propofol, Dunn et al (13) observed that 88.9% of the patients in the LA group subjectively classified their anesthesia as excellent or good, versus 77.4 in the BL group. In another randomized prospective study comparing spinal anesthesia and local anesthesia using propofol, Ben-David et al (10) found that 90% of the patients were very satisfied or satisfied in the two groups.…”

Section: Discussionmentioning

confidence: 99%

Estudo comparativo entre anestesia espinhal e anestesia local com infusão de propofol para artroscopia do joelho

Silva¹,

Matos²,

Madureira³

et al. 2012

Rev. bras. ortop.

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“…[1][2][3] La anestesia intrarticular para la cirugía artroscópica de rodilla es un procedimiento que ofrece ventajas sobre los otros tipos de anestesia, se realiza sin isquemia, tiene menores efectos hemodinámicos, 4 menor tiempo quirúrgico, disminuye la estadía hospitalaria, genera menos complicaciones, 5 logra una buena analgesia posoperatoria y el costo es inferior. [6][7][8][9][10] Los objetivos de este trabajo se pueden dividir en: Primarios (comparar la eficacia de la anestesia raquídea con la anestesia intrarticular en las artroscopias simples de rodilla) y Secundarios (evaluar la calidad de la anestesia, describir la incidencia de efectos adversos y determinar las complicaciones en ambos casos).…”

Section: Introductionunclassified

Anestesia raquídea versus anestesia intrarticular en cirugía artroscópica de rodilla. [Spinal anesthesia versus intra-articular anesthesia in arthroscopic surgery of the knee.]

Marangoni

Giacossa

Malvarez

et al. 2016

Rev. Asoc. Arg. Ort. y Traumatol

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258 ResumenIntroducción: La artroscopia de rodilla es el procedimiento quirúrgico más común para tratar pacientes con lesiones meniscales o condrales. El objetivo de este trabajo fue comparar la eficacia de la anestesia raquídea versus la intrarticular en artroscopias simples de rodilla, evaluar la calidad de la anestesia, describir la incidencia de los efectos adversos y determinar las complicaciones en ambos casos. Materiales y Métodos: Estudio prospectivo, aleatorizado para comparar dos procedimientos anestésicos mediante la evaluación de la edad, el tiempo de cirugía, la duración de la anestesia, el tiempo de internación, el dolor, la conformidad con el procedimiento y los costos. Se utilizó el test t de Student para las estadísticas y probabilidades. Nivel de significación: p <0,05. Resultados: Se incluyó a 70 pacientes, 35 fueron operados con anestesia intrarticular y 35, con anestesia raquídea. El tiempo de internación fue mayor en el grupo de anestesia raquídea (7.34 h; rango 4-11) que en el grupo de anestesia intrarticular (3.43 h; rango 2-5), p <0,0001. En la variable costo, hubo una diferencia significativa a favor de la anestesia intrarticular con respecto a la anestesia raquídea (p <0,0001). Conclusión: Las ventajas encontradas a favor de la anestesia intrarticular fueron: estadías hospitalarias acortadas, se evitaron efectos indeseables de la anestesia raquídea (bloqueo motor, náuseas, vómitos, hipotensión, pérdida transitoria de esfínter urinario y retención urinaria [globo vesical]); disminución de los costos y mayor aceptación de los pacientes.Palabras clave: Artroscopia de rodilla; anestesia local; anestesia intrarticular. Nivel de Evidencia: ISpinal anesthesia versus intra-articular anesthesia in arthroscopic surgery of the knee Abstract Introduction: Knee arthroscopy is the most common surgical procedure to treat patients with meniscal and/or chondral injuries. The aim of this study was to compare the efficacy of spinal vs. intra-articular anesthesia in knee arthroscopy, to assess the quality of anesthesia, to describe the incidence of adverse effects and to determine the complications in both cases. Methods: Prospective, randomized study to compare two anesthetic procedures evaluating age, duration of surgery, duration of anesthesia, length of hospitalization, pain, patient satisfaction and costs. Student t test was used for statistics and probabilities. Level of significance: p <0.05.

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A Prospective Randomized Comparison of Spinal Versus Local Anesthesia With Propofol Infusion for Knee Arthroscopy

Cited by 8 publications

References 17 publications

Comparative Study of Spinal and Local Anesthesia With Propofol Infusion for Knee Arthroscopy

Comparative Study of Spinal and Local Anesthesia With Propofol Infusion for Knee Arthroscopy

Estudo comparativo entre anestesia espinhal e anestesia local com infusão de propofol para artroscopia do joelho

Anestesia raquídea versus anestesia intrarticular en cirugía artroscópica de rodilla. [Spinal anesthesia versus intra-articular anesthesia in arthroscopic surgery of the knee.]

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