Unilateral spinal anesthesia with hyperbaric bupivacaine versus hyperbaric articaine in out-patient knee surgery

Abstract

Hemodynamic alterations due to sympathetic blockade during spinal anesthesia should be minimized. Restriction of sympathetic blockade during unilateral spinal anesthesia causes minimal hemodynamic alterations. The aim of this study was to compare the effect of hyperbaric bupivacaine and hyperbaric articaine on hemodynamic parameters and the level of sensory blockade for unilateral spinal anesthesia in outpatient knee arthroscopy. Twenty-seven patients undergoing elective lower extremity arthroscopy were included in this study. After spinal anesthesia in the lateral decubitus position. 15 patients in the bupivacaine group (Group B) were given 2 ml 0.5% hyperbaric bupivacaine and 12 patients in the articaine group (Group A) were given 1 ml 0.5% hyperbaric articaine. After the lateral position was maintained for 10 min. the final segmental blockade level and the degree of motor blockade on both the operated and unoperated sides were evaluated. Hemodynamic alterations and complications were also noted. There was no statistical difference between the groups with regards to hemodynamics, maximum sensorial blockade level, complications and number of patients in whom third degree motor blockade was achieved. However, two patients in the articaine group required general anesthesia due to inadequate surgical analgesia. In conclusion, unilateral spinal anesthesia could not be achieved with both of these techniques. However, both of these techniques can be safely used in outpatient arthroscopy for hemodynamic stability.