Turhan K S Cakar, Akmese R, Ozkan F, Okten F F
Department of Anesthesiology and ICU, Ankara University, Faculty of Medicine, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2015 Apr;19(8):1489-97.
In the current prospective, randomized study, we aimed to compare the effects of low dose selective spinal anesthesia with 5 mg of hyperbaric bupivacaine and single-shot femoral nerve block combination with conventional dose selective spinal anesthesia in terms of intraoperative anesthesia characteristics, block recovery characteristics, and postoperative analgesic consumption.
After obtaining institutional Ethics Committee approval, 52 ASA I-II patients aged 25-65, undergoing arthroscopic meniscus repair were randomly assigned to Group S (conventional dose selective spinal anesthesia with 10 mg bupivacaine) and Group FS (low-dose selective spinal anesthesia with 5mg bupivacaine +single-shot femoral block with 0.25% bupivacaine). Primary endpoints were time to reach T12 sensory block level, L2 regression, and complete motor block regression. Secondary endpoints were maximum sensory block level (MSBL); time to reach MSBL, time to first urination, time to first analgesic consumption and pain severity at the time of first mobilization.
Demographic characteristics were similar in both groups (p > 0.05). MSBL and time to reach T12 sensory level were similar in both groups (p > 0.05). Time to reach L2 regression, complete motor block regression, and time to first micturition were significantly shorter; time to first analgesic consumption was significantly longer; and total analgesic consumption and severity of pain at time of first mobilization were significantly lower in Group FS (p < 0.05).
The findings of the current study suggest that addition of single-shot femoral block to low dose spinal anesthesia could be an alternative to conventional dose spinal anesthesia in outpatient arthroscopic meniscus repair.
NCT02322372.
在当前这项前瞻性随机研究中，我们旨在比较低剂量（5mg重比重布比卡因）选择性脊髓麻醉与单次股神经阻滞联合传统剂量选择性脊髓麻醉在术中麻醉特征、阻滞恢复特征及术后镇痛药物消耗量方面的效果。
获得机构伦理委员会批准后，将52例年龄在25 - 65岁、接受关节镜半月板修复术的美国麻醉医师协会（ASA）I-II级患者随机分为S组（10mg布比卡因传统剂量选择性脊髓麻醉）和FS组（5mg布比卡因低剂量选择性脊髓麻醉 + 0.25%布比卡因单次股神经阻滞）。主要终点为达到T12感觉阻滞平面的时间、L2平面消退时间及完全运动阻滞消退时间。次要终点为最大感觉阻滞平面（MSBL）；达到MSBL的时间、首次排尿时间、首次使用镇痛药物的时间及首次活动时的疼痛严重程度。
两组患者的人口统计学特征相似（p > 0.05）。两组的MSBL及达到T12感觉平面的时间相似（p > 0.05）。FS组达到L2平面消退、完全运动阻滞消退及首次排尿的时间显著更短；首次使用镇痛药物的时间显著更长；且首次活动时的总镇痛药物消耗量及疼痛严重程度显著更低（p < 0.05）。
本研究结果表明，在门诊关节镜半月板修复术中，低剂量脊髓麻醉联合单次股神经阻滞可作为传统剂量脊髓麻醉的一种替代方法。
NCT02322372。
