SPINAL, EPIDURAL OR PROPOFOL ANESTHESIA FOR OUTPATIENT KNEE ARTHROSCOPY

Background: We have compared three different methods of anaesthesia fo r out-patient knee arthroscopy in terms of peri operative conditions, postoperative pain, time taken and economy. Methods: 91 ASA I-II patie nts scheduled for elective knee arthroscopy were included. After preme dication with diazepam 10 mg and naproxene 500 mg orally, they were ra ndomly assigned into one of three groups: Group S (n=32) received spin al anaesthesia with lidocaine 50 mg/ml 1.5-2 mi in 7.5% glucose throug h a 27-G Quincke needle, Group E (n=29) received epi dural anaesthesia with mepivacaine 20 mg/ml and epinephrine 5 mu g/ml, 15-20 mi, and Gr oup P (n=30) received propofol an aesthesia with a bolus induction of 2 mg/kg followed by infusion. Results: The time from start of anaesthe sia until start of operation was significantly less in Group P than in the two other Groups: 7.4 +/- 5.4 min as compared to 23.0 +/- 4.8 min in Group S and 31.0 +/- 9.1 min in Group E (mean +/- SD, P<0.05). Aft er end of surgery, the duration of the postoperative regional block wa s 75 +/- 28 min in Group S and 125 +/- 79 min in Group E (P<0.05). In Group S and Group E the postoperative pain was significantly :Less tha n in Group P at admission to the recovery unit and 60, 120 and 180 min later (P<0.05). The overall incidence of postoperative nausea or vomi ting was less than 5% with no differences between the groups. One pati ent in Group E had block failure and one patient in Group S had a post -spinal headache. The perioperative costs of drugs and disposables wer e highest in Group P (30 USD) and lowest in Group S (6.5 USD). Conclus ion: Propofol anaesthesia results in the shortest stay in the operatio n theatre but a higher degree of postoperative pain and a higher cost of drugs and disposables.