This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Korhonen, A.-M. Articles by Korttila, K. T. Search for Related Content PubMed PubMed Citation Articles by Korhonen, A.-M. Articles by Korttila, K. T. Related Collections Ambulatory Anesthetic Techniques Regional Anesthesia

---

AMBULATORY ANESTHESIA

A Comparison of Selective Spinal Anesthesia with Hyperbaric Bupivacaine and General Anesthesia with Desflurane for Outpatient Knee Arthroscopy

Anna-Maija Korhonen, MD^*,, Jukka V. Valanne, MD, PhD^*, Ritva M. Jokela, MD, PhD, Pirjo Ravaska, MD^*, and Kari T. Korttila, MD, PhD, FRCA

*Department of Anaesthesia, Lapland Central Hospital, Rovaniemi, Finland; Department of Anaesthesia and Intensive Care, University of Helsinki, Helsinki, Finland.

Address correspondence and reprint requests to Anna-Maija Korhonen, MD, HUCH, Department of Anaesthesia and Intensive Care Med, Meilahti Hospital, PO. Box 340, FIN-00029 HUS, Finland. Address e-mail to anna-maija.korhonen{at}hus.fi

In this randomized and controlled trial, 64 adult ambulatory knee arthroscopy patients received either selective spinal anesthesia (SSA) with 4 mg of hyperbaric bupivacaine or general anesthesia (GA) with desflurane. We conducted the study to determine whether SSA with small-dose bupivacaine provides equal fast-tracking possibilities, a shorter stay in the postanesthesia care unit, and earlier discharge home compared with GA with desflurane. Patients with a high risk for postoperative nausea and vomiting received prophylaxis in the GA group. No difference was seen in the fast-tracking possibilities or time in the postanesthesia care unit between the groups. Home readiness was achieved after 114 (31–174) and 129 (28–245) min (NS) in the SSA and GA groups, respectively. In the hospital, the pain scores were significantly (P < 0.001) lower in the SSA group compared with the GA group and the need for postoperative opioids was significantly (P = 0.008) larger after GA. The incidence of postoperative nausea and vomiting was 0% versus 19% in the SSA and GA groups (P = 0.024), respectively. We conclude that for outpatients undergoing knee arthroscopy, SSA with hyperbaric bupivacaine provides equal recovery times with less frequent side effects compared with GA with desflurane.

IMPLICATIONS: Patients undergoing ambulatory knee arthroscopy recover equally fast when using either selective spinal anesthesia with hyperbaric bupivacaine or general anesthesia with desflurane. Spinal anesthesia is associated with decreased pain scores and less postoperative nausea and vomiting in the hospital.

This article has been cited by other articles:

				C. Gonano, U. Leitgeb, C. Sitzwohl, G. Ihra, C. Weinstabl, and S. C. Kettner Spinal Versus General Anesthesia for Orthopedic Surgery: Anesthesia Drug and Supply Costs Anesth. Analg., February 1, 2006; 102(2): 524 - 529. [Abstract] [Full Text] [PDF]

				S. S. Liu, W. M. Strodtbeck, J. M. Richman, and C. L. Wu A Comparison of Regional Versus General Anesthesia for Ambulatory Anesthesia: A Meta-Analysis of Randomized Controlled Trials Anesth. Analg., December 1, 2005; 101(6): 1634 - 1642. [Abstract] [Full Text] [PDF]