Resumo

MONTES, Félix R et al. Comparación de anestesia espinal versus bloqueo nervioso ciático-femoral en pacientes ambulatorios sometidos a cirugía artroscópica de rodilla. Rev. colomb. anestesiol. [online]. 2007, vol.35, n.1, pp.45-52. ISSN 0120-3347.

Background: It has been suggested that use of regional anesthesia may have some potential benefits in the outpatient setting and result in decreased resource utilization, superior patient satisfaction, and better analgesia. The aim of this study was to compare the clinical properties of two widely used regional anesthetic techniques with regard to preparation for surgery and recovery from anesthesia in a standardized outpatient population. Methods: Following IRB approval, 50 ASA I-II adult outpatients undergoing arthroscopic knee surgery were enrolled. Study subjects were equally divided (n=25 each) into spinal (S) and sciatic-femoral (SF) groups. S patients received spinal anesthesia with 7.5 mg of 0.5% hyperbaric bupivacaine. SF 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 the readiness for surgery, as well as duration of surgery, recovery time and patient satisfaction were recorded. Analgesia and occurrence of adverse events were also registered. Results: There were no significant differences between the two groups in 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. Conclusions: For outpatient arthroscopic knee surgery, the use of a combined sciatic-femoral nerve block offers satisfactory anesthesia with a clinical profile similar to that obtained with low-dose spinal anesthesia. However, sciatic-femoral nerve blocks are associated with significantly lower pain scores during the first 6 postoperative hours.

Palavras-chave : anestesia; Sciatic-femoral block anesthesia; arthroscopic knee surgery.

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