Comparison of anesthesia quality for arthroscopic knee surgery: Combined sciatic femoral block and unilateral spinal anesthesia

Abstract

Objective: We aimed to evaluate the quality of anesthesia of combined sciatic and femoral 3-in-1 nerve blocks (CSFB) and unilateral spinal anesthesia technique with low-dose levobupivacaine in outpatients undergoing knee arthroscopy surgery. Materials and Methods: Forty American Society of Anesthesiologists (ASA) physical status I-II patients were randomly allocated into two groups and unilateral spinal anesthesia with low-dose levobupivacaine (group S, n=20) or CSFB (group B, n=20) was performed. Besides the quality of anesthesia, anesthetic effectiveness, hemodynamic values, duration of the technique application, maximum motor and sensorial block levels and durations, the first analgesics need, and total analgesic consumptions during postoperative 24 hours and determined complications were compared between the two groups. Results: The quality of anesthesia was better in group S, no patient received either sedation or analgesic intraoperatively while first analgesic need and number of patient was higher (p=0.014, p<0.001, p=0.032 respectively). The duration of technical application was shorter while maximum motor and sensorial block levels were higher in group S (p<0.0001, p=0.008, p<0.001 respectively). Motor block duration was significantly longer in group B (p<0.0001). Conclusion: We concluded that CSFB practice is an effective anesthetic alternative for unilateral spinal anesthesia.

Amaç: Günübirlik diz artroskopisi cerrahisinde kombine siyatik ve femoral üçü bir arada blok ile düşük doz levobupivakain ile yapılan tek taraflı spinal anestezi tekniklerinin anestezi kalitesini değerlendirmeyi amaçladık. Gereç ve Yöntemler: American Society of Anesthesiologists (ASA) I-II 40 hasta rastgele iki gruba ayrıldı ve tek taraflı spinal anestezi (grup S, n=20) veya kombine siyatik ve femoral üçü bir arada blok (grup B, n=20) uygulandı. Anestezi kalitesinin yanı sıra, hemodinamik değerler, teknik uygulama süresi, maksimum motor ve duyusal blok düzey ve süreleri, ilk analjezik gereksinimi ve postoperatif 24 saat süresince toplam analjezik tüketimi, saptanan komplikasyonlar iki grup arasında karşılaştırıldı.