Premium
Intrathecal ropivacaine 5 mg/ml for outpatient knee arthroscopy: a comparison with lidocaine 10 mg/ml
Author(s) -
FANELLI G.,
DANELLI G.,
ZASA M.,
BACIARELLO M.,
DI CIANNI S.,
LEONE S.
Publication year - 2009
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2008.01815.x
Subject(s) - ropivacaine , medicine , lidocaine , anesthesia , knee arthroscopy , local anesthetic , arthroscopy , surgery
Purpose: The aim of this prospective, randomised, blind study was to compare the evolution of spinal block produced with 50 mg lidocaine 10 mg/ml and 10 mg ropivacaine 5 mg/ml for outpatient knee arthroscopy. Methods: Thirty outpatients undergoing knee arthroscopy received 50 mg of lidocaine 10 mg/ml ( n =15) or 10 mg of ropivacaine 5 mg/ml ( n =15) intrathecally. The evolution of spinal block was recorded until home discharge, while the occurrence of transient neurologic symptoms (TNS) was evaluated through phone‐call follow‐ups. Results: The median onset time was 15 (10–21) min with lidocaine and 24 (11–37) min with ropivacaine ( P =0.109). Spinal lidocaine resulted in a faster resolution of sensory block [148 (130–167) min vs. 188 (146–231) ( P =0.022)], unassisted ambulation with crutches [176 (144–208) min vs. 240 (179–302) min ( P =0.014)], and voiding [208 (163–254) min vs. 293 (242–343) min ( P =0.001)] than ropivacaine. Recovery of motor function required 113 (95–131) min with lidocaine and 135 (87–183) with ropivacaine ( P =0.219). Six lidocaine patients reported TNS (40%) as compared with no patient receiving ropivacaine (0%) ( P =0.005). Conclusions: Spinal block produced with 10 mg ropivacaine 5 mg/ml is as effective as that produced by 50 mg of lidocaine 10 mg/ml. Recovery of unassisted ambulation and spontaneous voiding occurred earlier with lidocaine, but this was associated with a markedly higher incidence of TNS.