Peripheral nerve blocks give greater hemodynamic stability than general anesthesia for ASA III patients undergoing outpatient knee arthroscopy.

Autor: Bergmann, Ingo, Heetfeld, Maximilian, Crozier, Thomas, Schafdecker, Hans, Pöschl, Rupert, Wiese, Cristoph, Popov, Aron, Bauer, Martin, Hinz, Jose
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Zdroj: Central European Journal of Medicine; Aug2013, Vol. 8 Issue 4, p436-442, 7p
Abstrakt: Background: Outpatient surgery is increasingly being performed on patients with pre-existing cardiovascular and pulmonary disorders. These are relevant for anesthesia because of the inherent risk of hemodynamic instability. This study compared the hemodynamic course in ASA III patients undergoing knee arthroscopy with either peripheral block of the femoral and sciatic nerves or general anesthesia. Methods: We searched our patient database for ASA III patients who had undergone knee arthroscopy between 2005 and 2010. This is routinely performed in either regional or general anesthesia, and the patients were stratified according to the anesthetic. Hemodynamic parameters, process times, complications and postoperative pain documented in the charts were evaluated and compared. Results: 130 ASA III outpatients underwent knee arthroscopy during the observation period. Regional anesthesia alone (n=65) was sufficient in 96%. Heart rate was more stable and blood pressure decreased less under regional than under general anesthesia (systolic pressure − 11 ± 8% versus - 28 ± 9%; p < 0.001). Patients with general anesthesia (n=65) required more circulatory support. Establishing the nerve block takes longer than inducing general anesthesia, but this was performed ahead of time and thus had no effect on work flow. The groups did not differ with regard to complication rates, and intensity of postoperative pain or satisfaction with the anesthetic. No patient showed evidence of nerve damage or neurological deficits. Conclusions: Peripheral nerve block provides a more stable hemodynamic course than general anesthesia in ASA III patients undergoing knee arthroscopy. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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