naa a22 4500 510743595 CHVBK 20180411083037.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s12630-012-9867-5 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9867-5 Low-dose spinal bupivacaine for total knee arthroplasty facilitates recovery room discharge: a randomized controlled trial [Elektronische Daten] [Imad Awad, Jeffrey Cheung, Yaseen Al-Allaq, Patrick Conroy, Colin McCartney] Une faible dose de bupivacaïne intrathécale pour l'arthroplastie totale du genou facilite le congé de la salle de réveil: une étude randomisée contrôlée Purpose: Regional anesthesia is the preferred technique for total knee arthroplasty to provide a bridge for early postoperative analgesia, reduce opioid consumption, and improve mobility and rehabilitation. Multiple patient and process factors must be weighed when choosing the appropriate technique to reduce morbidity and facilitate discharge. We hypothesized that a low-dose of intrathecal bupivicaine combined with regional block would facilitate discharge from the postanesthesia care unit (PACU) and reduce postoperative morbidity. Methods: Patients undergoing total knee arthroplasty under spinal anesthesia received either 5 mg (low-dose group) or 10 mg (standard-dose group) isobaric bupivacaine in a double-blind randomized controlled trial. The primary outcome measure was time to achieve eligibility for PACU discharge. Secondary outcome measures included time to recovery of S2 dermatome sensation, time to voiding, rate of bladder catheterization, and time required for nursing intervention in the PACU and after discharge to the surgical ward. Results: Forty-five of the 49 recruited patients completed the study. Patients receiving low-dose spinal anesthesia were eligible for PACU discharge earlier than those receiving the standard dose (P=0.0036). Patients receiving the standard dose had significantly delayed recovery of S2 dermatome sensation (P=0.0035). There was no difference between groups in the amount of time required for nursing intervention in the PACU, but patients receiving low-dose spinal anesthesia required more time for nursing intervention within the first four hours of their arrival on the ward (P=0.009). None of the patients required intraoperative analgesic supplementation. Conclusions: In patients undergoing total knee arthroplasty, low-dose intrathecal bupivacaine (5 mg) combined with regional block is associated with a reduced time to achieve eligibility for discharge from the PACU. Canadian Anesthesiologists' Society, 2012 Awad Imad Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut Cheung Jeffrey Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut Al-Allaq Yaseen Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut Conroy Patrick Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut McCartney Colin Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 259-265 0832-610X 60:3<259 2013 60 12630 https://doi.org/10.1007/s12630-012-9867-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9867-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Awad Imad Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Cheung Jeffrey Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Al-Allaq Yaseen Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Conroy Patrick Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut NATIONALLICENCE 700 1- McCartney Colin Department of Anesthesia, M3-200, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 259-265 0832-610X 60:3<259 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer