Spinal anaesthesia for ambulatory arthroscopic surgery of the knee: a comparison of low-dose prilocaine and fentanyl with bupivacaine and fentanyl

A Black, G Newcombe, John Plummer, David McLeod, David Martin

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    28 Citations (Scopus)

    Abstract

    Background: Prospective data on the use of prilocaine for ambulatory spinal anaesthesia remain limited. We compared the behaviour and characteristics of subarachnoid block using prilocaine and fentanyl with that of bupivacaine and fentanyl.MethodsIn a prospective, double-blind, randomized controlled trial, 50 patients undergoing elective ambulatory arthroscopic knee surgery received subarachnoid anaesthesia, with either prilocaine 20 mg and fentanyl 20 g (Group P) or plain bupivacaine 7.5 mg and fentanyl 20 g (Group B). Primary endpoints included times for onset of maximum sensory block level and regression of sensory block to L4, and also motor block at 1 and 2 h, and levels of haemodynamic stability. Comparisons between the groups were made by χ 2 test for proportions and the MannWhitney test for ordinal data. Time-to-event data were analysed by the MannWhitney test for uncensored data or the logrank test for censored data.ResultsAt 2 h, motor block in Group P had fully resolved in 86 of patients, compared with 27 in Group B (P<0.001). Median time to regression of sensory block to L4 was significantly shorter in Group P (97 min) than in Group B (280 min) (P<0.001). A clinically significant decrease in arterial pressure was more common in Group B (73) than in Group P (32) (P0.004). Two patients in Group P required conversion to general anaesthesia, but for reasons unrelated to prilocaine itself.ConclusionsThe combination of prilocaine and fentanyl is a better alternative to that of low-dose bupivacaine and fentanyl, for spinal anaesthesia in ambulatory arthroscopic knee surgery.

    Original languageEnglish
    Pages (from-to)183-188
    Number of pages6
    JournalBritish Journal of Anaesthesia
    Volume106
    Issue number2
    DOIs
    Publication statusPublished - Feb 2011

    Keywords

    • ambulatory
    • prilocaine
    • spinal anaesthesia
    • TNS

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