A Comparison of Spinal, Epidural, and General Anesthesia for Outpatient Knee Arthroscopy

Mulroy, Michael F.; Larkin, Kathleen L.; Hodgson, Peter S.; Helman, James D.; Pollock, Julia E.; Liu, Spencer S.

doi:10.1097/00000539-200010000-00017

Cited by 138 publications

(65 citation statements)

References 14 publications

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“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] In 41 studies (5,548 patients), urinary retention or PVR with intrathecal anesthesia was assessed (Table 3), 11,13,16,17,20,22, and in 39 studies (4,938 patients), urinary retention or PVR with epidural anesthesia and/or analgesia was assessed (Table 4). 28,33,35,43,[48][49][50]54, An additional five studies involved both intrathecal and epidural techniques. There is overlap in the numbers of patients/studies reported for Tables 2, 3, and 4 because multiple outcomes and/or multiple neuraxial procedures were examined in several studies.…”

Section: Resultsmentioning

confidence: 99%

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Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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Purpose Urinary retention requiring catheterization carries the risk of infection. Neuraxial anesthesia causes transient impairment of bladder function ranging from delayed initiation of micturition to frank urinary retention. We undertook a review of the literature to determine the elements of neuraxial anesthesia and analgesia that prolong bladder dysfunction and increase the incidence of urinary retention. Methods We performed a systematic search of the PubMed, MEDLINE, and EMBASE databases (from January 1980 to January 2011) to identify studies where neuraxial anesthesia and/or analgesia were employed and at least one of the following outcomes was reported: urinary retention, time to micturition, or post void residual. We included randomized controlled trials and observational studies published in the English language and we excluded case reports. The randomized trials were graded according to the Jadad score. Principal findings Our search yielded 94 studies, and in 16 of these studies, the authors reported time to micturition after intrathecal anesthesia of varying local anesthetics and doses. Intrathecal injections were performed in 41 of these studies, epidural anesthesia/analgesia was used in 39 studies, and five studies involved both the intrathecal and epidural routes. Meta-analysis was not possible because of the heterogeneity of interventions and reported outcomes. The duration of detrusor dysfunction after intrathecal anesthesia is correlated with local anesthetic dose and potency. The incidence of urinary retention displays a similar trend and is further increased by the presence of neuraxial opioids, particularly long-acting variants. Urinary tract infection secondary to catheterization occurred rarely. Conclusions Neuraxial anesthesia/analgesia results in transient detrusor dysfunction. The duration of dysfunction depends on the potency and dose of medication used; however, it does not appear to result in significant morbidity.

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Section: Resultsmentioning

confidence: 99%

“…45,64 In contrast, studies in which either intrathecal fentanyl or sufentanil was utilized reported lower incidence rates ranging from 0 to 25%. 12,16,18,46,48,57,61 Kamphuis et al…”

Section: Resultsmentioning

confidence: 99%

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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“…The mean duration of the PACU stay for our unit was 91 ± 55 min. This compares with the PACU times of 104 ± 31min in units not using fast-track eligibility criteria 5 (ability to achieve the PACU discharge criteria) and 40 ± 13 min reported by other units using fasttrack criteria to abbreviate the duration of the PACU stay. 6,7 This suggests that implementation of fast-track eligibility criteria in our day unit would result in improved efficiency of the PACU.…”

Section: Me Et Th Ho Od Ds S the Surgical Day Unit (Sdu) In Vancouvmentioning

confidence: 68%

Mini-audits facilitate quality assurance in outpatient units

Padda

Vaghadia

2001

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : It has been shown that large-scale epidemiological studies are an unsatisfactory method of measuring quality of care in anesthesia. We performed a mini-audit of the outpatient surgery unit at Vancouver General Hospital to determine whether such methodology would be helpful in assessing and monitoring quality of care and in identifying areas where improvements could be made.M Me et th ho od ds s: : After institutional approval, we conducted a prospective quality assurance audit in a cohort of 462 consecutive outpatients. A measurement tool was developed using information from previous literature. Data recorded included demographics, type of surgery and anesthesia, duration of stay in the postanesthetic care unit (PACU) and any adverse events in the PACU. The effect of ethnicity on the above was also examined.R Re es su ul lt ts s: : The demographics and practice profiles of our unit were comparable to other units. The mean duration of stay in the PACU was 91 ± 55.3 min and is twice as long as other units. The incidence of hypotension, hypothermia and excessive pain in the PACU were higher compared to other centres. The incidence of other adverse events was comparable to that reported by other centres. O 2 supplementation was required more frequently in Caucasians (23% vs 9%; P <0.05) and postoperative bleeding occurred more frequently in Asiatics (46% vs 27%; P <0.05).C Co on nc cl lu us si io on n: : A mini-audit was found to be helpful in assessing and monitoring quality of care and in identifying areas where improvements could be made.O Ob bj je ec ct ti if f : : On a déjà démontré que les études épidémiologiques à grande échelle ne constituent pas une méthode satisfaisante de mesure de la qualité des soins en anesthésie. Nous avons réalisé un mini-audit de l unité de chirurgie ambulatoire au Vancouver General Hospital afin de déterminer si cette méthodologie pouvait être utile pour évaluer et surveiller la qualité des soins et pour identifier des domaines susceptibles d amélioration.M Mé ét th ho od de e : : Après avoir obtenu l accord de l hôpital, nous avons réalisé un audit prospectif sur l assurance qualité auprès d une cohorte de 462 patients ambulatoires successifs. Un instrument de mesure a été mis au point en utilisant des renseignements provenant de documentation déjà publiée sur le sujet. Les données comprenaient des informations personnelles, le type de chirurgie et d anesthésie, la durée du séjour en salle de réveil (SDR) et les événements défavorables qui ont pu y survenir. On a aussi vérifié l effet de l origine ethnique sur ces données.R Ré és su ul lt ta at ts s : : Les données démographiques et les profiles de pratique de notre unité ont été comparables à d autres unités. La durée moyenne du séjour en SDR a été de 91 ± 55,3 min, ce qui est deux fois plus long que dans les autres unités. Lincidence d hypotension, d hypothermie et de douleur intense à la SDR a été plus élevée, en comparaison avec d autres centres. Lincidence d autres événements indésirables a été compar...

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“…Poor postoperative analgesia may effect mobilization, duration of discharge, patient satisfaction, morbidity and mortality. The studies evaluating the effects of regional anesthesia (RA) on functional outcome after TKA were conducted [35][36][37][38][39]. The results of some studies have suggested that Regional anesthesia seems to improve the outcome of patients undergoing total hip or knee replacement when compared with general anesthesia [36].…”

Section: Knee Surgerymentioning

confidence: 99%

Regional Anesthesia Techniques in Orthopedic Surgery

Eroğlu¹

2016

JACCOA

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Background: The effect of regional anesthesia techniques on orthopedic surgeries is very actual topic in current clinical practice. Aim:The aim of this review article was to research regional anesthesia techniques for postoperative pain control and outcomes in orthopedic surgeries. Methods:The English literature was reviewed based on a search regional anesthesia and orthopedic surgery in clinical studies.Major findings: A number of authors proposed that regional anesthesia in orthopedic patients may be associated with better postoperative pain control and a reduction in intraoperative blood loss when compared with general anesthesia. Conclusion:In the future regional anesthesia techniques will be more preferable anesthetic technique in orthopedic surgeries.

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A Comparison of Spinal, Epidural, and General Anesthesia for Outpatient Knee Arthroscopy

Cited by 138 publications

References 14 publications

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

Mini-audits facilitate quality assurance in outpatient units

Regional Anesthesia Techniques in Orthopedic Surgery

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