Hatice TÜRE, Binnaz AY, Zeynep ETİ, F. Yılmaz GÖĞÜŞ

The comparison of the recovery characteristics of either spinal or epidural anesthesia with prilocaine for knee arthroscopy

Amaç: Bu calışma spinal ve epidural anestezide kullanılan tek doz prilokainin hastanın derlenme özellikleri üzerine etkisinin karşılaştırılması amacıyla planlanmıştır. Method: Diz artroskopisi geçirecek 40 hasta, 2 mL %2 prilokain ile spinal ya da 15-20 mL %2 prilokain ile epidural anestezi yapılacak şekilde randomize olarak 2 gruba ayrıldı. Hastaların maksimum duyu bloğu seviyeleri, motor ve duyu bloğunun geri dönüş süreleri, ayağa kalkma zamanları, ilk idrar yapma zamanları, yan etkiler ve tedavisinde kullanılan ilaçlar kaydedildiler. Hastalar taburcu olduktan 48 saat sonra, telefonla aranarak, operasyon sonrası ağrıları, analjezik ihtiyaçları, anestezi yönteminden memnuniyetleri, bulantı, kusma, kaşıntı, belağrısı, dura delinmesine bağlı baş ağrısı, idrar yaparken zorlanma ve geçici nörolojik semptomlar açısından sorgulandılar. Bulgular: Maksimum duyu bloğu seviyesi her iki grupta benzerdi. İlacın verilişinden duyu ve motor bloğun sonlanmasına dek geçen süre ve ayağa kalkma süresi epidural anestezi sonrası belirgin kısa bulundu (p < 0.05). Ek analjezik kullanan hasta sayısı, spinal anestezi sonrası %9 iken, epidural anestezi sonrası %6 idi. Spinal gruptan bir hastada dura delinmesine bağlı başağrısı görüldü. Hastaların hiçbirinde postoperatif bulantı, kusma, kaşıntı, bel ağrısı, idrar zorluğu ya da gecici norolojik semptomlar görülmedi. Hasta memnuniyeti açısından gruplar arasında fark bulunmadı. Sonuç: Hızlı derlenme süresi nedeniyle prilokain ile epidural anestezi diz artroskopilerinde iyi bir alternatiftir.

Diz artroskopisi cerrahisinde prilokain ile yapılan spinal ve epidural anestezinin derlenme özelliklerinin karşılaştırılması

Objective: The aim of our study was to compare the recovery characteristics of single-dose spinal and epidural anesthesia with 2 % prilocaine for outpatient knee arthroscopy. Methods: Forty patients were randomly assigned to receive either spinal or epidural with prilocaine. Maximum sensory level, recovery of the motor and sensorial functions, time to ambulate, time to voiding, side effects, and medications used for treatment were recorded. After 48 hours, the patients were questioned for pain and need for analgesia, their opinion about the quality of anesthesia, side effects such as nausea, vomiting, pruritus, backache, post-dural puncture headache (PDPH), urinary difficulties and transient neurological symptoms (TNS). Results: Maximum sensory level was similar in the groups. The time from injection to recovery of motor and sensory functions and ambulation time were significantly shorter in the epidural group than the spinal group (p < 0.05). The percentage of patients who required additional analgesic was 9% versus 6% in spinal versus epidural groups. One of the patients in the spinal group had PDPH postoperatively. None of the patients had postoperative nausea, vomiting, pruritus, backache, urinary difficulties or TNS. Conclusion: Relatively fast recovery time make epidural anesthesia with prilocaine a good alternative for outpatient knee arthroscopy.

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