Montes Felix R, Zarate Eduardo, Grueso Reinaldo, Giraldo Juan C, Venegas Maria P, Gomez Andrea, Rincón Jose D, Hernadez Marcela, Cabrera Mariana
Department of Anesthesiology, Fundación Cardio Infantil-Instituto de Cardiología, Universidad del Rosario, Bogotá, Colombia.
J Clin Anesth. 2008 Sep;20(6):415-20. doi: 10.1016/j.jclinane.2008.04.003.
To compare spinal anesthesia and combined sciatic-femoral nerve block for outpatient knee arthroscopy.
Prospective, randomized, controlled study.
Postoperative recovery area at a university-affiliated medical center.
50 ASA physical status I and II adult outpatients undergoing arthroscopic knee surgery.
Study subjects were equally divided (n = 25 each) into spinal and sciatic-femoral groups. Spinal group patients received spinal anesthesia with 7.5 mg of 0.5% hyperbaric bupivacaine. Sciatic-femoral group patients received combined sciatic-femoral nerve blocks using a mixture of 20 mL of lidocaine 2% plus 20 mL of bupivacaine 0.5%.
Times including that from arrival in the operating room to readiness for surgery, duration of surgery, recovery time, and patient satisfaction were recorded. Analgesia and occurrence of adverse events also were recorded.
No significant differences between the two groups were found for any of the study measurements of recovery. After discharge, postoperative pain differed significantly between groups only at 6 hours (P < 0.002). Patient satisfaction was high with both techniques.
Combined sciatic-femoral nerve block for outpatient arthroscopic knee surgery offers satisfactory anesthesia, with a clinical profile similar to that of low-dose spinal anesthesia. Sciatic-femoral nerve blocks are associated with significantly lower pain scores during the first 6 postoperative hours.
比较脊髓麻醉与坐骨-股神经联合阻滞用于门诊膝关节镜检查的效果。
前瞻性、随机、对照研究。
大学附属医院的术后恢复区。
50例美国麻醉医师协会（ASA）身体状况为I级和II级的成年门诊患者，接受膝关节镜手术。
研究对象被平均分为脊髓麻醉组和坐骨-股神经联合阻滞组（每组n = 25）。脊髓麻醉组患者接受7.5 mg 0.5% 重比重布比卡因的脊髓麻醉。坐骨-股神经联合阻滞组患者接受2%利多卡因20 mL加0.5%布比卡因20 mL混合液的坐骨-股神经联合阻滞。
记录从进入手术室到准备手术的时间、手术持续时间、恢复时间和患者满意度。还记录镇痛情况和不良事件的发生情况。
两组在任何恢复相关的研究测量指标上均未发现显著差异。出院后，仅在术后6小时两组间术后疼痛存在显著差异（P < 0.002）。两种技术的患者满意度均较高。
坐骨-股神经联合阻滞用于门诊膝关节镜手术可提供满意的麻醉效果，其临床特征与低剂量脊髓麻醉相似。坐骨-股神经联合阻滞在术后前6小时的疼痛评分显著更低。
