ED50 and ED90 of intrathecal hyperbaric 2% prilocaine in ambulatory knee arthroscopy

Guntz, Emmanuel; Latrech, Bausard; Tsiberidis, Constantin C.; Gouwy, Jonathan; Kapessidou, Yota

doi:10.1007/s12630-014-0189-7

Cited by 21 publications

(31 citation statements)

References 26 publications

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“…In arthroscopy knee surgery, Guntz et al performed a dose finding study using 2% hyperbaric prilocaine 30. With the up-and-down sequential allocation technique, Guntz estimated the effective dose 90 of 2% hyperbaric prilocaine to be 38.5 mg for patients undergoing knee arthroscopy under spinal anesthesia.…”

Section: Resultsmentioning

confidence: 99%

Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review

Manassero¹,

Fanelli²

2017

LRA

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Prilocaine is a local anesthetic characterized by intermediate potency and duration and fast onset of action. As hyperbaric formulation of 5% solution, it was introduced and has been successfully used for spinal anesthesia since 1960. A new formulation of 2% plain and hyperbaric solution is currently available in Europe. Because of its lower incidence of transient neurological symptoms, prilocaine is suggested as substitute to lidocaine and mepivacaine in spinal anesthesia for ambulatory surgery, as well as a suitable alternative to low doses of long-acting local anesthetics. The National Library of Medicine database, the Excerpta Medica database, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials database, were searched for the period 1970 to September 2016, with the aim to identify studies evaluating the intrathecal use of 2% prilocaine. A total of 13 randomized clinical trials (RCTs), 1 observational study, 2 dose finding, and 4 systematic reviews has been used for this review. The studies evaluated showed that 2% hyperbaric prilocaine due to a favorable anesthetic and safety profile is an alternative drug to lidocaine and mepivacaine for spinal anesthesia of intermediate or short duration. In comparison with plain solutions, hyperbaricity remarkably accelerates the onset and offset times of intrathecal 2% prilocaine. Literature suggests a dose ranging between 40 and 60 mg of prilocaine for lower extremities and lower abdominal procedures lasting up to 90 min, whereas a dose ranging from 10 to 30 mg is appropriate for perineal surgery. Readiness for discharge occurs in ~4 h from spinal administration.

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Section: Resultsmentioning

confidence: 99%

Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review

Manassero¹,

Fanelli²

2017

LRA

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“…En esta serie, la media de edad que con mayor frecuencia se presentó fue en el grupo etario de entre 60-69 años, 28.3% en el Grupo AS y 35.0% en el Grupo IA, sin que existieran diferencias significativas (p = 0.683). Se puede señalar que no existe consenso en la literatura con respecto a la frecuencia de edades (3,12,15,(22)(23)(24)(25)(26)(27)(29)(30)(31)(32)(33) .…”

Section: Discussionunclassified

Bloqueo regional intraarticular con anestésicos locales en cirugía artroscópica de rodilla

Cordero-Escobar¹,

Chico-Capote²,

Escobar-Andarade³

et al. 2020

Revista Mexicana De Anestesiología

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RESUMEN. Introducción: La técnica anestésica de elección para la artroscopía está determinada por los requerimientos quirúrgicos intraoperatorios y pretende optimizar la recuperación, el control del dolor postoperatorio y facilitar el alta precoz. Objetivo: Evaluar los resultados del bloqueo regional intraarticular con anestésicos locales en la cirugía artroscópica de rodilla. Material y métodos: Se realizó un estudio observacional, descriptivo, de corte transversal para evaluar los resultados del bloqueo regional intraarticular con anestésicos locales en la cirugía artroscópica de rodilla, en el Hospital Clínico Quirúrgico «Hermanos Ameijeiras», en el período comprendido entre febrero de 2013 y febrero de 2016. El estudio incluyó un total de 120 pacientes, distribuidos en dos grupos de 60 cada uno. Grupo AS: se utilizó anestesia subaracnoidea y Grupo AI: se realizó anestesia intraarticular con anestesia local. Resultados: El grupo etario más frecuente fue entre 60-69 años, 28.3% en el Grupo AS y 35.0% en el Grupo IA, sin diferencias significativas (p = 0.683). Predominó el sexo femenino sobre el masculino (42/18 vs 44/16), sin diferencias significativas (p = 0.839). Predominó el ASA I, en 56.7 y 43.3%, según técnica anestésica, sin diferencias significativas (p = 0.092). La rodilla derecha predominó sobre la izquierda. La entidad nosológica más frecuente fue la plica presente en 58.3% del Grupo AS y 60% en el Grupo IA (p = 0.408). La osteoartritis de rodilla, según grupos, se presentó en 46.7 % en el grupo AS y en 50.0% del grupo AI. El dolor postoperatorio estuvo presente en 21.7% del grupo AS y en 10% en el Grupo IA. Existieron diferencias significativas entre grupos (p = 0.0114). Las complicaciones según grupos, se presentaron en el doble de pacientes del grupo AS (30%) que en el Grupo IA (15%) con diferencias significativas (p = 0.049). Conclusiones: Los resultados del bloqueo regional intraarticular con anestésicos locales en la cirugía artroscópica de rodilla constituye una técnica anestésica fácil de realizar y que brinda seguridad al paciente. ABSTRACT. Introduction: The anesthetic technique of choice for arthroscopy is determined by the intraoperative surgical requirements and aims to optimize recovery, postoperative pain control and facilitate early discharge. Objective:To evaluate the results of intra-articular regional block with local anesthetics in arthroscopic knee surgery. Material and methods: An observational, descriptive, cross-sectional study was conducted to evaluate the results of the intraarticular regional block with local anesthetics in arthroscopic knee surgery at the «Hermanos Ameijeiras» Clinical Surgical Hospital, in the period between February 2013 and February 2016. The study included a total of 120 patients, distributed in two groups of 60 each. Group AS: subarachnoid anesthesia and Group AI: intra-articular regional block with local anesthetics. Results: The most frequent age group was between 60-69 years, 28.3% in group SA and 35.0% in group IA, without significant differences (...

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“…4 In our previously published study, we determined the effective doses (ED 50 and ED 90 ) of intrathecal hyperbaric prilocaine for patients undergoing ambulatory knee arthroscopy. 5 The minimum effective dose for patients undergoing knee arthroscopy (ED 50 ) of hyperbaric 2% prilocaine was 28.9 mg, whereas the ED 90 was 38.5 mg. In our study, all patients met the discharge criteria after 205 min and could spontaneously urinate.…”

Section: To the Editormentioning

confidence: 99%

Spinal prilocaine for same-day surgery: the importance of equipotent doses

Guntz

Kapessidou

2016

Can J Anesth/J Can Anesth

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ED50 and ED90 of intrathecal hyperbaric 2% prilocaine in ambulatory knee arthroscopy

Abstract: This study determined the ED50 of HP is 28.9 mg and suggests that a 40-mg dose of HP is adequate to provide successful spinal anesthesia for outpatient knee arthroscopy.

Cited by 21 publications

References 26 publications

Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review

Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review

Bloqueo regional intraarticular con anestésicos locales en cirugía artroscópica de rodilla

Spinal prilocaine for same-day surgery: the importance of equipotent doses

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