Comparison of hemodynamics, recovery profile and postoperative analgesia of unilateral spinal anaesthesia with combined sciatic-femoral nerve block in knee arthroscopy
Muhammed Murat Kurnaz1, Ayşın Ersoy2, Aysel Altan3, Zekeriya Ervatan2, Nurdan Ünlü2
1Giresun Prof.dr. A.ilhan Özdemir Hospital,department Of Anesthesiology And Intensive Care
2Okmeydani Training And Research Hospital,department Of Anesthesiology And Intensive Care
3Kafkas University,department Of Anesthesiology And Intensive Care
Keywords: Anesthetic techniques, knee arthroscopy; femoral block; levobupivacaine; sciatic block; unilateral spinal.
Abstract
Objectives: In this randomized, controlled, blind study, a combined sciatic-femoral nerve block with levobupivacaine was compared with a unilateral spinal anaesthesia with respect to effectiveness, patient and surgeon satisfaction, and the effect on postoperative pain in arthroscopic knee surgery.
Methods: Patients were randomly divided into two groups. Group I (n=20) received a combined sciatic-femoral nerve block with levobupivacaine 0.5% totalling 40 ml. In group II (n=20), a spinal anaesthesia in the lateral decubitus position (ULSA) with 7.5mg levobupivacaine 0.5% was performed, and patients were kept in the same position to achieve an anaesthesia level of T12 (maximum 10 minutes). The development of motor and sensorial block on both sides and onset time to surgical anaesthesia were recorded. The time required for the postoperative recovery score to be ≥12 was recorded. In the postoperative period, postoperative analgesia (VAS), motor block, side effects, and patient and surgeon satisfaction were recorded at the 1st, 3rd, 6th and 12th hours.
Results: Time of readiness for surgery was significantly shorter in Group II (p<0.05). All patients were satisfied with both techniques. There were no differences in judgement between the groups. VAS scores at the 6th hour were significantly lower in group I than in group II (p<0.05).
Conclusion: Combined sciatic-femoral nerve block for outpatient arthroscopic knee surgery offers satisfactory anaesthesia, 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.