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Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study = Prilocaïne 2 % hyperbare versus ropivacaïne 0,4 % en injection intrathécale pour une arthroscopie du genou en chirurgie ambulatoire: une étude randomisée contrôlée prospective à double insu

Aguirre, José ; Borgeat, Alain ; Bühler, Philipp ; Mrdjen, Jelena ; Hardmeier, Beat ; Bonvini, John

In: Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2015, vol. 62, no. 10, p. 1055-1062

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    Title
    • Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study
    Translated Title ()
    • Prilocaïne 2 % hyperbare versus ropivacaïne 0,4 % en injection intrathécale pour une arthroscopie du genou en chirurgie ambulatoire: une étude randomisée contrôlée prospective à double insu
    Author
    • Aguirre, José. Division of Anesthesiology, Balgrist University Hospital Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
    • Borgeat, Alain. Division of Anesthesiology, Balgrist University Hospital Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
    • Bühler, Philipp. Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
    • Mrdjen, Jelena. Hospital Lachen, Institute of Anesthesiology, Lachen, Switzerland
    • Hardmeier, Beat. Hospital Lachen, Institute of Anesthesiology, Lachen, Switzerland
    • Bonvini, John. Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2015, vol. 62, no. 10, p. 1055-1062. Springer US; http://www.springer-ny.com
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:332531
    Summary
    Background: Short-duration spinal anesthesia is a good option for ambulatory knee surgery. Hyperbaric 2% prilocaine has short onset and rapid recovery times and, therefore, may be well suited in this setting. The aim of this study was to compare the times to reach motor block, motor block resolution, and discharge from the postanesthesia care unit (PACU) between hyperbaric 2% prilocaine and 0.4% plain ropivacaine. Methods: In this prospective randomized double-blind study, 140 patients (ages 18-80 yr and American Society of Anesthesiologists physical status I-II) scheduled for elective unilateral arthroscopic knee surgery lasting < 45 min were allocated to either 3 mL of 2% prilocaine (60 mg) or 3 mL of 0.4% plain ropivacaine (12 mg). Time to reach complete recovery of motor block, time to reach criteria for discharge, as well as side effects up to 48 hr after discharge were recorded. Results: The median (interquartile range [IQR]) time to recovery from the motor block was faster in the 2% prilocaine group compared with the 0.4% ropivacaine group (180 [169-240] min vs 240 [180-300] min, respectively; median difference, 60 min, 95% confidence interval (CI), 23 to 97 min; P = 0.036). The median [IQR] time to reach discharge criteria was similar between the two groups (330 [295-365] min vs, 335 [290-395] min; median difference 5 min, 95% CI, −25 to 35 min; P = 0.330). The incidence of side effects was low and similar in both groups. No case of transient neurologic symptoms occurred in either group. Conclusion: The recovery of motor block was faster after intrathecal administration of hyperbaric 2% prilocaine compared with 0.4% plain ropivacaine; however, discharge time was similar between the two groups. Both drugs showed a similar risk profile.