ambulatory surgery
Use of spinal anaesthesia in day surgery. [Curr Opin Anaesthesiol. 2006] – PubMed Result
Review of spinal anesthetics in day surgery.
Use of spinal anaesthesia in day surgery. [Curr Opin Anaesthesiol. 2006] – PubMed Result .
A Shorter Spinal: Case Discussion for the Week of May 4, 2009
25 year-old female presents for knee arthroscopy and MCL repair.
This is her 7th knee scope in the past 4 years. While discussing the anesthetic plan for GA, the patient becomes quite distraught. She mentions that she is terrified of going to sleep.
“Back home in Seattle, they used to just do a spinal and let me [...]
Ambulatory continuous femoral nerve blocks decrease time to discharge readiness after tricompartment total knee arthroplasty: a randomized, triple-masked, placebo-controlled study.
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Related Articles |
Ambulatory continuous femoral nerve blocks decrease time to discharge readiness after tricompartment total knee arthroplasty: a randomized, triple-masked, placebo-controlled study.
Anesthesiology. 2008 Apr;108(4):703-13
Authors: Ilfeld BM, Le LT, Meyer RS, Mariano ER, Vandenborne K, Duncan PW, Sessler DI, Enneking FK, Shuster JJ, Theriaque DW, Berry LF, Spadoni EH, Gearen PF
BACKGROUND: The authors tested the hypotheses that, compared with an overnight continuous femoral nerve block (cFNB), a 4-day ambulatory cFNB increases ambulation distance and decreases the time until three specific readiness-for-discharge criteria are met after tricompartment total knee arthroplasty. METHODS: Preoperatively, all patients received a cFNB (n = 50) and perineural ropivacaine 0.2% from surgery until the following morning, at which time they were randomly assigned to either continue perineural ropivacaine or switch to perineural normal saline. Primary endpoints included (1) time to attain three discharge criteria (adequate analgesia, independence from intravenous analgesics, and ambulation of at least 30 m) and (2) ambulatory distance in 6 min the afternoon after surgery. Patients were discharged with their cFNB and a portable infusion pump, and catheters were removed on postoperative day 4. RESULTS: Patients given 4 days of perineural ropivacaine attained all three discharge criteria in a median (25th-75th percentiles) of 25 (21-47) h, compared with 71 (46-89) h for those of the control group (estimated ratio, 0.47; 95% confidence interval, 0.32-0.67; P <0.001). Patients assigned to receive ropivacaine ambulated a median of 32 (17-47) m the afternoon after surgery, compared with 26 (13-35) m for those receiving normal saline (estimated ratio, 1.21; 95% confidence interval, 0.71-1.85; P = 0.42). CONCLUSIONS: Compared with an overnight cFNB, a 4-day ambulatory cFNB decreases the time to reach three important discharge criteria by an estimated 53% after tricompartment total knee arthroplasty. However, the extended infusion did not increase ambulation distance the afternoon after surgery. (ClinicalTrials.gov No. NCT00135889.).
PMID: 18362603 [PubMed - indexed for MEDLINE]
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