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Published on: November 21, 2025
Comparison between two different selective spinal anesthesia techniques in ambulatory knee arthroscopy as fast-track
Hossam Ibrahim Eldesuky Ali Hassan1
1Department of Anesthesia and Critical Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Low-dose lidocaine spinal anesthesia enables faster recovery and eligibility for fast-tracking after knee arthroscopy compared to bupivacaine. Lidocaine offers shorter ambulation and home-readiness times with similar safety profiles.
Area of Science:
- Anesthesiology
- Orthopedic Surgery
Background:
- Previous studies explored low-dose bupivacaine or lidocaine for unilateral selective spinal anesthesia (SSA) in ambulatory knee arthroscopy.
- Concerns existed regarding high failure rates, complications, and prolonged home readiness with these techniques.
Purpose of the Study:
- Compare clinical efficacy and side effects of two SSA techniques for ambulatory knee arthroscopy.
- Evaluate potential for shorter post-anesthesia care unit (PACU) stays or fast-tracking eligibility.
- Compare ambulation and home readiness times.
Main Methods:
- Prospective, randomized study of 50 outpatients undergoing knee arthroscopy.
- Group B: 3 mg bupivacaine + 10 ug fentanyl intrathecally, maintained lateral decubitus for 20 min.
- Group L: 20 mg lidocaine + 25 ug fentanyl intrathecally, immediately supine.
Main Results:
- Bupivacaine group (Group B) had longer motor and sensory block durations than lidocaine group (Group L).
- No significant difference in postoperative side effects between groups.
- All Group L patients bypassed PACU (P < 0.001), with shorter ambulation and home-readiness times compared to Group B.
Conclusions:
- Both SSA techniques are clinically effective with low side effects.
- Lidocaine spinal anesthesia is more suitable for fast-tracking, offering shorter ambulation and home-readiness times.
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