Comparison between intrathecal hyperbaric bupivacaine and levobupivacaine for ambulatory knee arthroscopy

• 作者: Ahmet Koroglu Ismail Aslan Mehmet Erduran Ozlem Sagir Sabri Ozaslan Yucel Meric
• 来源期刊: 世界麻醉学杂志
• 学科: 医学
• 关键词: Spinal anesthesia Knee ARTHROSCOPY OUTPATIENT surgery BUPIVACAINE LEVOBUPIVACAINE
• 年，卷（期）: 2013,（3）
• 页码范围: 18-25
• 页数: 8页
• 分类号: R

摘要

AIM:To compare the effect of hyperbaric levobupivacaine and bupivacaine on the quality of the block,patient satisfaction,and discharge time in patients undergoing arthroscopic knee surgery under unilateral spinal anesthesia.METHODS:One hundred and thirty-two patients,American Society of AnaesthesiologistsⅠorⅡ,scheduled for elective ambulatory knee arthroscopy were randomly assigned to four double-blind groups.To achieve a unilateral spinal block,Group BF received 5 mg of hyperbaric bupivacaine plus 20μg of fentanyl intrathecally,Group LF received 5 mg of hyperbaric levobupivacaine plus 20μg of fentanyl intrathecally,Group B received 5 mg of hyperbaric bupivacaine intrathecally,and Group L received 5 mg of hyperbaric levobupivacaine intrathecally.The level and duration of the sensory block,the intensity and duration of the motor block,the time to first analgesic requirement,and the time elapsed until the patient’s discharge were recorded.Hemodynamic values and adverse effects were also recorded.RESULTS:The duration of time needed to reach the T12 dermatome level was significantly longer in Group L[7(3-20)min]than in Group B[6(3-12)min](P=0.006).The maximum sensory level reached on the side undergoing the operation was significantly higher in Group BF than in Group B(P<0.05).The intensity of the motor blockade was greater in Group BF than in Group LF and L.Complete recovery from motor blockade occurred earlier in Groups LF[75(45-165)min]and L[63(35-120)min]than in Group BF[115(60-180)min](P<0.05).The length of time needed for the sensory block to regress to the level of S2 was shorter in Group L(154±50)than in Group BF(192±66)(P<0.05).The quality of the block was significantly lower in Group L than in Groups BF,LF and B(P=0.012,P=0.003,and P<0.001,respectively).The time elapsed until Visual Analog Scale≥4 was significantly shorter in Group L(110±48)than in Groups BF(200±60),LF(156±61)and B(162±52)(P<0.05).The time elapsed until the patient’s discharge was shorter in Groups B(244±54)and L(229±55)