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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 1/2010

01-01-2010 | Reports of Original Investigations

Spinal mepivacaine with fentanyl for outpatient knee arthroscopy surgery: a randomized controlled trial

Authors: Dermot O’Donnell, MD, Baskar Manickam, MD, Anahi Perlas, MD, Reena Karkhanis, MD, Vincent W. S. Chan, MD, Khalid Syed, MD, Richard Brull, MD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 1/2010

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Abstract

Background

The foremost limitation of local anesthetic solutions for spinal anesthesia in the outpatient setting is prolonged motor blockade and delayed ambulation. The purpose of this study was to determine if the addition of intrathecal fentanyl to low-dose spinal mepivacaine provides adequate anesthesia with shorter duration of functional motor blockade for ambulatory knee surgery compared with spinal mepivacaine alone.

Methods

Following institutional review board approval and informed consent, 34 patients undergoing unilateral knee arthroscopy were enrolled in this study. The patients were randomly assigned to receive either 30 mg of isobaric mepivacaine 1.5% plus fentanyl 10 μg (M + F group) or 45 mg of isobaric mepivacaine 1.5% alone (M group) intrathecally. Postoperatively, the times to achieve sensory block regression to the S1 dermatome and to attain functional motor block recovery enabling ambulation were recorded. All assessments were blinded.

Results

The time to completion of Phase I recovery was shorter in the M + F group (104.6 ± 28.4 min) than in the M group (129.1 ± 30.4 min; P = 0.023). Regression of sensory blockade to S1 was earlier in the M + F group (118.4 ± 53.5 min) than in the M group (169.7 ± 38.9 min; P = 0.003). Patients in the M + F group (176.4 ± 40.3 min) were able to ambulate significantly earlier than those in the M group (205.6 ± 31.4 min; P = 0.025). No cases of transient or persistent neurological dysfunction were noted.

Conclusions

When compared with 45 mg isobaric mepivacaine 1.5%, an intrathecal dose of 30 mg isobaric mepivacaine 1.5% plus 10 μg fentanyl produces reliable anesthesia, hastens block regression, shortens stay in Phase I recovery, and enables earlier ambulation for patients undergoing unilateral knee arthroscopy (Registration no. NCT00803725).
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Metadata
Title
Spinal mepivacaine with fentanyl for outpatient knee arthroscopy surgery: a randomized controlled trial
Authors
Dermot O’Donnell, MD
Baskar Manickam, MD
Anahi Perlas, MD
Reena Karkhanis, MD
Vincent W. S. Chan, MD
Khalid Syed, MD
Richard Brull, MD
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 1/2010
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-009-9207-6

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