Document Detail


Spinal mepivacaine with fentanyl for outpatient knee arthroscopy surgery: a randomized controlled trial.
MedLine Citation:
PMID:  19856040     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The foremost limitation of local anesthetic solutions for spinal anesthesia in the outpatient setting is prolonged motor blockade and delayed ambulation. The purpose of this study was to determine if the addition of intrathecal fentanyl to low-dose spinal mepivacaine provides adequate anesthesia with shorter duration of functional motor blockade for ambulatory knee surgery compared with spinal mepivacaine alone. METHODS: Following institutional review board approval and informed consent, 34 patients undergoing unilateral knee arthroscopy were enrolled in this study. The patients were randomly assigned to receive either 30 mg of isobaric mepivacaine 1.5% plus fentanyl 10 microg (M + F group) or 45 mg of isobaric mepivacaine 1.5% alone (M group) intrathecally. Postoperatively, the times to achieve sensory block regression to the S1 dermatome and to attain functional motor block recovery enabling ambulation were recorded. All assessments were blinded. RESULTS: The time to completion of Phase I recovery was shorter in the M + F group (104.6 +/- 28.4 min) than in the M group (129.1 +/- 30.4 min; P = 0.023). Regression of sensory blockade to S1 was earlier in the M + F group (118.4 +/- 53.5 min) than in the M group (169.7 +/- 38.9 min; P = 0.003). Patients in the M + F group (176.4 +/- 40.3 min) were able to ambulate significantly earlier than those in the M group (205.6 +/- 31.4 min; P = 0.025). No cases of transient or persistent neurological dysfunction were noted. CONCLUSIONS: When compared with 45 mg isobaric mepivacaine 1.5%, an intrathecal dose of 30 mg isobaric mepivacaine 1.5% plus 10 microg fentanyl produces reliable anesthesia, hastens block regression, shortens stay in Phase I recovery, and enables earlier ambulation for patients undergoing unilateral knee arthroscopy (Registration no. NCT00803725).
Authors:
Dermot O'Donnell; Baskar Manickam; Anahi Perlas; Reena Karkhanis; Vincent W S Chan; Khalid Syed; Richard Brull
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-10-24
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesth?sie     Volume:  57     ISSN:  1496-8975     ISO Abbreviation:  Can J Anaesth     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  32-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Mc Laughlin Pavilion 2-405, 399 Bathurst Street, Toronto, ON, M5T-2S8, Canada.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00803725
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ambulatory Surgical Procedures / methods
Analgesics, Opioid / administration & dosage,  therapeutic use
Anesthesia Recovery Period
Anesthesia, Spinal / methods
Anesthetics, Local / administration & dosage,  therapeutic use
Arthroscopy / methods*
Double-Blind Method
Drug Therapy, Combination
Female
Fentanyl / administration & dosage,  therapeutic use*
Humans
Injections, Spinal
Knee Joint / surgery
Male
Mepivacaine / administration & dosage,  therapeutic use*
Middle Aged
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Local; 437-38-7/Fentanyl; 96-88-8/Mepivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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