Spinal anesthesia with chloroprocaine 1% versus total intravenous anesthesia for outpatient knee arthroscopy
Gebhardt V, Zawierucha V, Schöffski O, Schwarz A, Weiss C, Schmittner MD (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 35
Pages Range: 774–781
DOI: 10.1097/EJA.0000000000000794
Abstract
BACKGROUND:
Both general and spinal anaesthesia with short-acting local anaesthetics are suitable and reliable for knee arthroscopy as an ambulatory procedure. Chloroprocaine (CP) 1% seems to be the ideal spinal local anaesthetic for this indication.
OBJECTIVE:
The aim of this study was to compare spinal anaesthesia using CP 1% with general for outpatient knee arthroscopy with regard to procedure times, occurrence of pain, patient satisfaction and recovery, and also costs.
DESIGN:
A randomised controlled single-centre trial.
SETTING:
University Medical Centre Mannheim, Department of Anaesthesiology and Surgical Intensive Care Medicine, Mannheim, Germany. April 2014 to August 2015.
PATIENTS:
A total of 50 patients (women/men, 18 to 80 years old, ASA I to III) undergoing outpatient knee arthroscopy were included. A contra-indication to an allocated anaesthetic technique or an allergy to medication required in the protocol led to exclusion.
INTERVENTIONS:
Either general anaesthesia with sufentanil, propofol and a laryngeal mask for airway-management or spinal with 40-mg CP 1% were used. We noted procedure times, patient satisfaction/recovery and conducted a 7-day follow-up.
MAIN OUTOMES:
Primary outcome was duration of stay in the day-surgery centre. Secondary outcomes were first occurrence of pain, patient satisfaction, quality of recovery and adverse effects. In addition, we analysed treatment costs.
RESULTS:
Spinal had faster recovery than general anaesthesia with patients reaching discharge criteria significantly earlier [117 min (66 to 167) versus 142 min (82 to 228), P = 0.0047]. Pain occurred significantly earlier in the general anaesthesia group (P = 0.0072). Costs were less with spinal anaesthesia (cost ratio spinal: general 0.57). Patients felt significantly more uncomfortable after general anaesthesia (P = 0.0096).
CONCLUSION:
Spinal anaesthesia with 40-mg CP 1% leads to a significantly earlier discharge and is cheaper compared with general.
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Involved external institutions
Germany (DE)How to cite
APA:
Gebhardt, V., Zawierucha, V., Schöffski, O., Schwarz, A., Weiss, C., & Schmittner, M.D. (2018). Spinal anesthesia with chloroprocaine 1% versus total intravenous anesthesia for outpatient knee arthroscopy. European Journal of Anaesthesiology, 35, 774–781. https://doi.org/10.1097/EJA.0000000000000794
MLA:
Gebhardt, Volker, et al. "Spinal anesthesia with chloroprocaine 1% versus total intravenous anesthesia for outpatient knee arthroscopy." European Journal of Anaesthesiology 35 (2018): 774–781.
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