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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2004 November;70(11):763-9

language: English, Italian

Prilocaine or mepivacaine for combined sciatic-femoral nerve block in patients receiving elective knee arthroscopy

Marsan A. 1, Kirdemir P. 1, Mamo D. 2, Casati A. 2

1 Ankara Numune Teaching and Research Hospital Department of Anesthesiology, Ankara, Turkey
2 “Vita-Salute” University Department of Anesthesiology IRCCS Hospital San Raffaele, Milan, Italy


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Aim. The aim of this study was to evaluate the onset time of surgical block, recovery of motor function and duration of post-operative analgesia of combined sciatic-femoral nerve block performed with either mepivacaine or prilocaine.
Methods. With Ethical Committee approval and written informed consent, 30 ASA physical status I-II patients, undergoing elective arthroscopic knee surgery, received a combined sciatic-femoral nerve block with 30 ml of either 2% mepivacaine (n=15) or 1% prilocaine (n=15). An independent observer recorded the onset time of sensory and motor blocks, the need for intraoperative analgesia supplementation, recovery of motor function, and first request of post-operative pain medication.
Results. Onset time of nerve block required 15±5 min with prilocaine and 12±7 min with mepivacaine (p=0.33). No patient required general anesthesia to complete surgery; 3 patients receiving prilocaine (20%) and 2 patients receiving mepivacaine (13%) required 0.1 mg fentanyl intravenously to complete surgery (p=0.99). Recovery of motor function and first request of post-operative pain medication occurred after 238±36 min and 259±31 min with prilocaine, and 220±48 min and 248±47 min with mepivacaine (p=0.257 and p=0.43, respectively). Patient satisfaction was good in all studied patients.
Conclusion. Prilocaine 1% provides adequate sensory and motor block for arthroscopic knee surgery, with a clinical profile similar to that produced by 2% mepivacaine, and may be a good option for surgical procedures of intermediate duration and not associated with severe postoperative pain.

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