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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTHESIA
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
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.