Comparison of the Effects of Combined Neuraxial Anesthesia and Multicomponent Low-Flow Inhalation Anesthesia in the Structure of Perioperative Anesthetic Management in Patients Undergoing Arthroscopic Interventions on the Knee Joint

Abstract

Abstract. Arthroscopic knee surgery (AKS) is one of the most common types of surgery in the world. But there is still a debate about the optimal type of anesthetic management for this type of orthopedic surgery. The purpose of the study was to improve the quality of anesthetic management of arthroscopic interventions on the knee joint by introducing personalized perioperative anesthesia management. Materials and methods: 142 patients, aged 18-78 years, who were planned for AKS, took part in the study. The patients were randomized into 2 groups according to the type of anesthesia chosen by the patient. In the first group (n1 = 82) patients underwent neuraxial anesthesia in combination with intravenous administration of dexmedetomidine, in the second group (n2 = 60) – multicomponent low-flow inhalation anesthesia with sevoflurane in combination with multimodal analgesia. Before the operation, the level of preoperative stress was assessed. During the first 24 hours after surgery, the level of postoperative pain was assessed by the VAS, the incidence of PONV, and overall patient satisfaction with the surgery. Results: the level of pain according to the VAS, the incidence of PONV, the level of satisfaction in the study groups did not differ significantly. Conclusions: Neuraxial and general anesthesia for arthroscopic knee surgery has advantages and disadvantages. The patient’s choice of one or another type of anesthetic aid was significantly influenced by the level of preoperative stress. Decision-making on the method of anesthesia should be based on the patient’s wishes and possible previous surgical experience.