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Low-dose, low-concentration levobupivacaine plus fentanyl selective spinal anesthesia for knee arthroscopy: a dose
Jesus De Santiago1, Javier Santos-Yglesias, Jorge Giron
1Department of Anesthesiology, Hospital USP La Colina, SC de Tenerife, 38006 Tenerife, Spain. jdesantiagom@gmail.com
Background:
Selective sensory spinal anesthesia preserves lower limb motor function and thus facilitates postanesthesia care unit (PACU) bypass and reduces ambulation recovery time.
Methods:
We compared the ambulation time and PACU bypass rate after using 3 low-dose, low-concentration levobupivacaine-fentanyl spinal solutions (5, 4, and 3 mg + 10 μg) in a double-blind study consisting of 90 patients (ASA physical status I and II) scheduled to undergo knee arthroscopy.
Results:
The 3-mg dose was halted because of a large number of inadequate blocks (50%). Twenty-three percent and 80% of patients from groups 5 mg and 4 mg, respectively, bypassed the PACU (P = 0001). Ambulation took place after 70 minutes (30-130 minutes) (median [range]) in group 5 mg and 45 minutes (23-120 minutes) in group 4 mg (P = 0006).
Conclusion:
Four milligrams levobupivacaine plus 10 μg fentanyl produced adequate surgical anesthesia with the shortest time to ambulation and the highest PACU bypass rate.
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