EPIDURAL ANAESTHESIA

SINGLE-SHOT FOR DAY-CASE KNEE ARTHROSCOPY USING A 50-50 MIXTURE OF LIGNOCAINE AND BUPIVACAINE

Authors

  • AZMAT RIAZ PAF Hospital, Islamabad.
  • HAMID SAEED MALIK Military Hospital, Rawalpindi
  • BILAL YASIN Consultant Anesthesiologist CMH, Kharian.

DOI:

https://doi.org/10.29309/TPMJ/2010.17.02.2440

Keywords:

Epidural anaesthesia, local anaesthetics, lignocaine, bupivacaine, day case surgery, epidural fentanyl

Abstract

Objectives: To compare the benefits and adverse effects of three different drug combinations when used for single-shot epidural anaesthesia for day-case arthroscopy. Design of Study: Prospective, random, double-blind study. Setting: A 250 bedded secondary care hospital. Period: From October 2005 to Feb 2007. Material and Methods: We studied 75 adult male patients, aged between 23 to 63 years, weight <100 kg, ASA physical status I or II undergoing elective knee arthroscopy as day-case procedure. Patients were randomly divided into three groups ( 25 patients in each group) and single-shot epidural anaesthesia was performed using a total of 20 ml epidural lignocaine 2% (Group 1) bupivacaine 0.5% (Group 2) or a mixture containing lignocaine 2% and bupivacaine 0.5%, 10 ml each (Group 3). Results: Time to achieve maximum height (in minutes) was similar in group-1 and group-3 (10±4 and 11±2), but it was significantly longer in group-2 (20±3). Block time was comparable in group-2 and 3 (130±25 and 118±37) but it was significantly shorter in group-1 (60±20). Post-operative discharge time was longest in the group-2, and comparable in group-1 and 3.The incidence of complications like bradycardia, hypotension, nausea and vomiting were more in group-2 and less in group-1 and group-3. Inadequate anaesthesia was more in group-1 and least in other two groups.
Four patients of group-1 needed rescue analgesia and two from same group needed general anaesthesia as compared to none in group-2 and group-3. In 4-point patient satisfaction scale, maximum patients from Group-3 rated it perfect while most patients from group-1 were not satisfied with the quality of anaesthesia. Conclusions: The results of our study show that a 50-50 mixture of lignocaine and bupivacaine with
fentanyl 50 μg when used for single-shot epidural anaesthesia for day case knee arthroscopy, provides better quality of analgesia, with fewer incidences of side effects and more patient satisfaction as compared to lignocaine or bupivacaine alone.

Author Biographies

AZMAT RIAZ, PAF Hospital, Islamabad.

MBBS, MCPS, FCPS 

Consultant Anesthesiologist

HAMID SAEED MALIK, Military Hospital, Rawalpindi

MBBS, FCPS

Consultant Pathologist

BILAL YASIN, Consultant Anesthesiologist CMH, Kharian.

MBBS, FCPS

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Published

2010-06-10