Low-dose spinal bupivacaine for total knee arthroplasty facilitates recovery room discharge: a randomized controlled trial

Optimal dose of intrathecal isobaric bupivacaine in total knee arthroplasty

“…This needs to be examined in new studies. 12 The results of our study are consistent with the recent study by Mathijssen et al (unpublished data), which examined the median effective dose of bupivacaine in total hip arthroplasty (THA). In this study a median dose of 5.7 mg (95% CI 5.2 to 6.1) bupivacaine was sufficient for No dose adjustments were made for bodyweight or height since no hard evidence has been found that this influences spinal anesthesia outcomes.…”

“…3 Awad et al found significantly earlier recovery room discharge after TKA with low-dose (5 mg) isobaric bupivacaine in combination with a femoral and sciatic nerve block compared with their standard 10-mg dosage. 12 We presume it might be feasible to reduce the dosage of bupivacaine to optimize the rehabilitation after primary TKA.…”

Incidence and related factors for intraoperative failed spinal anaesthesia for lower limb arthroplasty

“…These numbers are conservative as we chose only to include patients were conversion to general anaesthesia was necessary, thus not considering those cases where supplement of analgesics or propofol were necessary to continue with the procedure, but not requiring intubation/laryngeal mask placement, or those where an attempt of intrathecal injection failed. Previous smaller studies have reported zero cases of failed spinal anaesthesia 18 , potentially due to lack of power (n=45),.…”

Anaesthesia and analgesia for knee joint arthroplasty

“…Recently 5 mg intrathecal isobaric bupivacaine has been shown to provide adequate anaesthesia for up to an average surgical time of 66 minutes. 10 However, this low dose of intrathecal bupivacaine is not standard practice. In combination with femoral nerve block (FNB) and/or sciatic nerve block (SNB) 5 mg intrathecal bupivacaine facilitates earlier recovery room discharge as well as reducing the incidence of urinary retention.…”

“…In combination with femoral nerve block (FNB) and/or sciatic nerve block (SNB) 5 mg intrathecal bupivacaine facilitates earlier recovery room discharge as well as reducing the incidence of urinary retention. 10 Some agents may be co-administered with LAs in an attempt to enhance the quality of neural blockade. Commonly used agents have included vasoconstrictors (epinephrine), opioids (diamorphine, morphine, or fentanyl) and a-2 receptor agonists (clonidine).…”