Effectiveness and safety of exclusive spinal anesthesia with bupivacaine versus femoral sciatic block during the postoperative period of patients having undergone knee arthroscopy: systematic review
Keywords:
Arthroscopy, Knee, Anesthesia, Spinal, Nerve Block, Bupivacaine
Abstract
Introduction:
Spinal anesthesia (SA) and sciatic-femoral nerve block are the most widely used anesthesia techniques for knee arthroscopy; however, there is still some controversy with regard to which anesthetic procedure offers improved safety, better pain control, and higher patient satisfaction.
Objective:
To assess the effectiveness of exclusive SA with bupivacaine versus sciatic-femoral nerve block, regardless of the drug, during the postoperative period of patients having undergone knee arthroscopy, through a systematic review of the scientific literature.
Methods:
A search of Randomized Clinical Trials was conducted in a number of databases including Ovid, Cochrane, Embase, Lilacs, Open Grey, ClinicalTrials.gov, and academic Google. The snowball technique was also used to identify additional trials. The design of the search strategy included Boolean operators and considered studies in English, Spanish, and Portuguese, with no date restrictions. The information is presented in narrative form.
Results:
The search identified 478 studies, of which 3 met the eligibility criteria. The effectiveness was evaluated based on total anesthesia time and rescue analgesia. Safety was evaluated with heart rate monitoring and time to first micturition. Patient satisfaction was identified through surveys to measure the acceptance of the anesthetic technique.
Conclusion:
SA is effective as assessed based on the motor-sensory blockade effect and pain control, but its adverse events shall be taken into consideration when making a decision. The anesthetic techniques of the peripheral sciatic-femoral nerve block present less undesirable side effects than spinal analgesia and provide better postoperative pain control.
References
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2. García M, Cugat R. History of Arthroscopy. Rev Esp Artroscopia 1994;1:9-15.
3. Ruiz Valverde WE, Hidalgo Cisneros FM. Valoración del dolor postoperatorio en pacientes de 18 años y 45 años de edad con artroscopia de rodilla con anestesia local atendidos en el servicio de Ortopedia y Traumatología del Hospital Metropolitano de Quito en el periodo agosto 2012-agosto 2015. [Cited 2017 Oct 06]. Available at: http://www.dspace.uce.edu.ec/handle/25000/10864.
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5. Miranda-Rangel A, Martínez-Segura RT. Multimodal anesthesia: a vision of modern anesthesia. Rev Mex Anestesiol 2015;38 (suppl. 1):S300-S301.
6. Choquet O, Zetlaoui PJ. Peripheral regional anesthesia techniques lower limb. EMC Anest Reanim 2015;41:1-24.
7. Sánchez Contreras MD. Evaluación de la eficacia de tres técnicas analgésicas, analgesia epidural, bloqueo femoral continuo y doble bloqueo femoral y ciático continuo en la artroplastia total de rodilla. [Internet]. Valencia: Facultad de Medicina y Odontología Departamento de Cirugía; 2015. [Cited 2017 Oct 06]. Available at: https://core.ac.uk/download/pdf/71052735.pdf.
8. Ramírez-Gómez M, Schlufter-Stolberg RM. Sciatic-femoral block, three in one. Rev Mex Anestesiol 2010;33:79-87.
9. Whizar-Lugo V, Flores-Carrillo JC, Preciado-Ramírez S, et al. Spinal anesthesia for ambulatory surgery in plastic surgery. Anest Mex 2017;29 (suppl 1):41-63.
10. Borghi B, Stagni F, Bugamelli S, et al. Unilateral spinal block for outpatient knee arthroscopy: a dose-finding study. J Clin Anesth 2003;15:351-356.
11. Geier KO. ‘3-in-1’ blockade: partial, total or overdimensioned block? Correlation between anatomy, clinic and radio images. Rev Bras Anestesiol 2004;54:566-572.
12. Abdulatif M, Fawzy M, Nassar H, et al. The effects of perineural dexmedetomidine on the pharmacodynamic profile of femoral nerve block: a dose-finding randomised, controlled, double-blind study. Anaesthesia 2016;71:1177-1185.
13. Jáuregui A, Siboney G. Eficacia analgésica del bloqueo femoral guiado por ultrasonido, para cirugía de rodilla, en el Centenario Hospital Miguel Hidalgo. [Internet]. Sinaloa: Universidad Autonoma de Aguas Calientes; 2017. [Cited 2017 Oct 06]. Available at: http://bdigital.dgse.uaa.mx:8080/xmlui/handle/123456789/1278.
14. Zetlaoui PJ. Locoregional anesthesia and analgesia in medical practice. EMC-Tratado de Medicina 2018;22:1-10.
15. Capurro J, Sforsini CD. Seguridad en anestesia loco-regional (ALR): complicaciones de los bloqueos nerviosos periféricos. Rev Argent Anestesiol 2012;70:101-112.
16. Casati A, Cappelleri G, Fanelli G, et al. Regional anaesthesia for outpatient knee arthroscopy: a randomized clinical comparison of two different anaesthetic techniques. Acta Anaesthesiol Scand 2000;44:543-547.
17. Bonet A, Sabate A, Otero I, et al. Ultrasound-guided saphenous nerve block is an effective technique for perioperative analgesia in ambulatory arthroscopic surgery of the internal knee compartment. Rev Esp Anestesiol Reanim 2015;62:428-435.
18. Flores, WR. Prevalencia de dolor post quiriirgico inmediata utilizando escala Eva en pacientes de 20 a 50 años de edad sometidos a Artroscopia de rodilla por trastorno interno de rodilla sin la utilización de torniquete en el Hospital Enrique Garcés, Quito-Ecuador, periodo de enero 2015 a enero 2017. [Internte]. Quito: UCE; 2017. [Cited 2018 Oct 18]. Available at: http://www.dspace.uce.edu.ec/handle/25000/16135.
19. González Gavilanez AM, Vicuña Pozo MF, Villena Galarza MV, et al. Management of postoperative pain in patients undergoing arthroscopic surgery. Rev Cubana Reumatol 2017;19:111-118.
20. Peña Atrio GA, Aguilar Román F, Torres García J, et al. Bupivacaine as a local anesthetic in knee arthroscopies. Rev Cubana de Ortop Traumatol 1999;13:27-30.
21. Aydin F, Akan B, Susleyen C, et al. Comparison of bupivacaine alone and in combination with sufentanil in patients undergoing arthroscopic knee surgery. Knee Surg Sports Traumatol Arthrosc 2011;19:1915-1919.
22. Ates Y, Kinik H, Bínnet MS, Ates Y, Canakci N, Kecik Y. Comparison of prilocaine and bupivacaine for post-arthroscopy analgesia: a placebo-controlled double-blind trial. Arthroscopy: Arthroscopic 1994;10:108-109.
23. Higgins DGA, Gotzsche PC, Jüni P, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.
24. The Nordic Cochrane Centre; The Cochrane Collaboration Review Manager (RevMan) [Computer program]. Version 5.3. The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen:2014.
25. Centro Cochrane Iberoamericano. Manual Cochrane de Revisiones sistemáticas. [Internet]. [Cited 2018 Oct 18]. Available at: https://es.cochrane.org/sites/es.cochrane.org/files/public/uploads/Manual_Cochrane_510_reduit.pdf.
26. Spasiano A, Flore I, Pesamosca A, et al. Comparison between spinal anaesthesia and sciatic-femoral block for arthroscopic knee surgery. Minerva Anestesiol 2007;73:13-21.
27. Montes FR, Zárate E, Grueso R, et al. Comparison between spinal anaesthesia and sciatic-femoral block for arthroscopic knee surgery. Rev Colomb Anestesiol 2007;35:45-52.
28. Sarmiento Álvarez KA. Anestesia raquídea con dosis mínimas efectivas de bupivacaina hiperbárica al 0, 5% más opioide versus anestesia raquídea con dosis habituales a pacientes sometidos a artroscopias del hospital Manuel Ygnacio Monteros de la ciudad de Loja, periodo abril 2013-enero 2014. [Internet]. Loja: Universidad Nacional de Loja; 2014. [Cited 2018 Oct 18]. Available at: http://dspace.unl.edu.ec/handle/123456789/18751.
29. Imbelloni LE, Volpato Passarini G, Ganem EM, et al. Comparative study between combined sciatic-femoral nerve block, via a single skin injection, and spinal block anesthesia for unilateral surgery of the lower limb. Rev Bras Anestesiol 2010;60:588-592.
30. Whizar-Lugo VM, Flores-Carrillo JC, Preciado-Ramírez S, et al. Controversy in subarachnoid anesthesia. Anestesia en México 2004;16:241-250.
31. Nadal JL, Yera M, Vargas G, et al. Postoperative analgesia in arthroscopic knee surgery. Multicentric Study. Rev Cubana de Anestesiol Reanim 2003;2:31-36.
32. Marangoni LD, Giacossa R, Malvarez A, et al. Spinal anesthesia versus intra-articular anesthesia in arthroscopic surgery of the knee. Rev Asoc Argent Ortop Traumatol 2016;81:258-263.
33. Marrón-Peña GM. Adverse events of neuraxial anesthesia ¿What to do when they occur? Rev Mex Anestesiol 2007;30 (s1):357-375.
34. Martínez Navas A. Complications of peripheral nerve blocks. Rev Esp Anestesiol Reanim 2006;53:237-248.
35. Pellicer G, Gómez R, Martínez F. Bloqueos nerviosos periféricos en la extremidad inferior para la analgesia postoperatoria de la artroplastia total de rodilla. [Internet]. Zaragoza: Universidad de Zaragoza; 2014. [Cited 2018 Oct 18]. Available at: Available at: /www.tdx.cat/handle/10803/134145 .
36. Contreras-Domínguez VA, Carbonell-Bellolio P, Ojeda-Greciet Á, et al. Extended three-in-one block versus intravenous analgesia for postoperative pain management after reconstruction of anterior cruciate ligament of the knee. Rev Bras Anestesiol 2007;57:280-288.
37. Vloka JD, Hadzic A, Mulcare R, et al. Combined popliteal and posterior cutaneous nerve of the thigh blocks for short saphenous vein stripping in outpatients: an alternative to spinal anesthesia. J Clin Anesth 1997;9:618-622.
38. Calvo R, Figueroa D, Arellano S, et al. Femoral nerve block in anterior cruciate ligament surgery; a prospective randomised trial. Rev Chil Ortop Traumatol 2016;57:14-19.
39. Muñiz M, Rodríguez J, Escudero JA, et al. Peripheral nerve blocks for surgical anesthesia and postoperative analgesia of the lower extremity. Rev Esp Anestesiol Reanim 2003;50:510-520.
40. Bajo Pesini R, del Cojo Peces E, Delgado García I, et al. Management of postoperative pain in knee arthroplasty/arthroscopy in Spain. Lack of anaesthetic department support. Rev Soc Esp Dolor 2010;17:89-98.
2. García M, Cugat R. History of Arthroscopy. Rev Esp Artroscopia 1994;1:9-15.
3. Ruiz Valverde WE, Hidalgo Cisneros FM. Valoración del dolor postoperatorio en pacientes de 18 años y 45 años de edad con artroscopia de rodilla con anestesia local atendidos en el servicio de Ortopedia y Traumatología del Hospital Metropolitano de Quito en el periodo agosto 2012-agosto 2015. [Cited 2017 Oct 06]. Available at: http://www.dspace.uce.edu.ec/handle/25000/10864.
4. Reyes Fierro A, de la Gala García F. Local anaesthesia as elective technique for arthroscopic knee surgery. Patol Ap Locomotor 2004;2:87-89.
5. Miranda-Rangel A, Martínez-Segura RT. Multimodal anesthesia: a vision of modern anesthesia. Rev Mex Anestesiol 2015;38 (suppl. 1):S300-S301.
6. Choquet O, Zetlaoui PJ. Peripheral regional anesthesia techniques lower limb. EMC Anest Reanim 2015;41:1-24.
7. Sánchez Contreras MD. Evaluación de la eficacia de tres técnicas analgésicas, analgesia epidural, bloqueo femoral continuo y doble bloqueo femoral y ciático continuo en la artroplastia total de rodilla. [Internet]. Valencia: Facultad de Medicina y Odontología Departamento de Cirugía; 2015. [Cited 2017 Oct 06]. Available at: https://core.ac.uk/download/pdf/71052735.pdf.
8. Ramírez-Gómez M, Schlufter-Stolberg RM. Sciatic-femoral block, three in one. Rev Mex Anestesiol 2010;33:79-87.
9. Whizar-Lugo V, Flores-Carrillo JC, Preciado-Ramírez S, et al. Spinal anesthesia for ambulatory surgery in plastic surgery. Anest Mex 2017;29 (suppl 1):41-63.
10. Borghi B, Stagni F, Bugamelli S, et al. Unilateral spinal block for outpatient knee arthroscopy: a dose-finding study. J Clin Anesth 2003;15:351-356.
11. Geier KO. ‘3-in-1’ blockade: partial, total or overdimensioned block? Correlation between anatomy, clinic and radio images. Rev Bras Anestesiol 2004;54:566-572.
12. Abdulatif M, Fawzy M, Nassar H, et al. The effects of perineural dexmedetomidine on the pharmacodynamic profile of femoral nerve block: a dose-finding randomised, controlled, double-blind study. Anaesthesia 2016;71:1177-1185.
13. Jáuregui A, Siboney G. Eficacia analgésica del bloqueo femoral guiado por ultrasonido, para cirugía de rodilla, en el Centenario Hospital Miguel Hidalgo. [Internet]. Sinaloa: Universidad Autonoma de Aguas Calientes; 2017. [Cited 2017 Oct 06]. Available at: http://bdigital.dgse.uaa.mx:8080/xmlui/handle/123456789/1278.
14. Zetlaoui PJ. Locoregional anesthesia and analgesia in medical practice. EMC-Tratado de Medicina 2018;22:1-10.
15. Capurro J, Sforsini CD. Seguridad en anestesia loco-regional (ALR): complicaciones de los bloqueos nerviosos periféricos. Rev Argent Anestesiol 2012;70:101-112.
16. Casati A, Cappelleri G, Fanelli G, et al. Regional anaesthesia for outpatient knee arthroscopy: a randomized clinical comparison of two different anaesthetic techniques. Acta Anaesthesiol Scand 2000;44:543-547.
17. Bonet A, Sabate A, Otero I, et al. Ultrasound-guided saphenous nerve block is an effective technique for perioperative analgesia in ambulatory arthroscopic surgery of the internal knee compartment. Rev Esp Anestesiol Reanim 2015;62:428-435.
18. Flores, WR. Prevalencia de dolor post quiriirgico inmediata utilizando escala Eva en pacientes de 20 a 50 años de edad sometidos a Artroscopia de rodilla por trastorno interno de rodilla sin la utilización de torniquete en el Hospital Enrique Garcés, Quito-Ecuador, periodo de enero 2015 a enero 2017. [Internte]. Quito: UCE; 2017. [Cited 2018 Oct 18]. Available at: http://www.dspace.uce.edu.ec/handle/25000/16135.
19. González Gavilanez AM, Vicuña Pozo MF, Villena Galarza MV, et al. Management of postoperative pain in patients undergoing arthroscopic surgery. Rev Cubana Reumatol 2017;19:111-118.
20. Peña Atrio GA, Aguilar Román F, Torres García J, et al. Bupivacaine as a local anesthetic in knee arthroscopies. Rev Cubana de Ortop Traumatol 1999;13:27-30.
21. Aydin F, Akan B, Susleyen C, et al. Comparison of bupivacaine alone and in combination with sufentanil in patients undergoing arthroscopic knee surgery. Knee Surg Sports Traumatol Arthrosc 2011;19:1915-1919.
22. Ates Y, Kinik H, Bínnet MS, Ates Y, Canakci N, Kecik Y. Comparison of prilocaine and bupivacaine for post-arthroscopy analgesia: a placebo-controlled double-blind trial. Arthroscopy: Arthroscopic 1994;10:108-109.
23. Higgins DGA, Gotzsche PC, Jüni P, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.
24. The Nordic Cochrane Centre; The Cochrane Collaboration Review Manager (RevMan) [Computer program]. Version 5.3. The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen:2014.
25. Centro Cochrane Iberoamericano. Manual Cochrane de Revisiones sistemáticas. [Internet]. [Cited 2018 Oct 18]. Available at: https://es.cochrane.org/sites/es.cochrane.org/files/public/uploads/Manual_Cochrane_510_reduit.pdf.
26. Spasiano A, Flore I, Pesamosca A, et al. Comparison between spinal anaesthesia and sciatic-femoral block for arthroscopic knee surgery. Minerva Anestesiol 2007;73:13-21.
27. Montes FR, Zárate E, Grueso R, et al. Comparison between spinal anaesthesia and sciatic-femoral block for arthroscopic knee surgery. Rev Colomb Anestesiol 2007;35:45-52.
28. Sarmiento Álvarez KA. Anestesia raquídea con dosis mínimas efectivas de bupivacaina hiperbárica al 0, 5% más opioide versus anestesia raquídea con dosis habituales a pacientes sometidos a artroscopias del hospital Manuel Ygnacio Monteros de la ciudad de Loja, periodo abril 2013-enero 2014. [Internet]. Loja: Universidad Nacional de Loja; 2014. [Cited 2018 Oct 18]. Available at: http://dspace.unl.edu.ec/handle/123456789/18751.
29. Imbelloni LE, Volpato Passarini G, Ganem EM, et al. Comparative study between combined sciatic-femoral nerve block, via a single skin injection, and spinal block anesthesia for unilateral surgery of the lower limb. Rev Bras Anestesiol 2010;60:588-592.
30. Whizar-Lugo VM, Flores-Carrillo JC, Preciado-Ramírez S, et al. Controversy in subarachnoid anesthesia. Anestesia en México 2004;16:241-250.
31. Nadal JL, Yera M, Vargas G, et al. Postoperative analgesia in arthroscopic knee surgery. Multicentric Study. Rev Cubana de Anestesiol Reanim 2003;2:31-36.
32. Marangoni LD, Giacossa R, Malvarez A, et al. Spinal anesthesia versus intra-articular anesthesia in arthroscopic surgery of the knee. Rev Asoc Argent Ortop Traumatol 2016;81:258-263.
33. Marrón-Peña GM. Adverse events of neuraxial anesthesia ¿What to do when they occur? Rev Mex Anestesiol 2007;30 (s1):357-375.
34. Martínez Navas A. Complications of peripheral nerve blocks. Rev Esp Anestesiol Reanim 2006;53:237-248.
35. Pellicer G, Gómez R, Martínez F. Bloqueos nerviosos periféricos en la extremidad inferior para la analgesia postoperatoria de la artroplastia total de rodilla. [Internet]. Zaragoza: Universidad de Zaragoza; 2014. [Cited 2018 Oct 18]. Available at: Available at: /www.tdx.cat/handle/10803/134145 .
36. Contreras-Domínguez VA, Carbonell-Bellolio P, Ojeda-Greciet Á, et al. Extended three-in-one block versus intravenous analgesia for postoperative pain management after reconstruction of anterior cruciate ligament of the knee. Rev Bras Anestesiol 2007;57:280-288.
37. Vloka JD, Hadzic A, Mulcare R, et al. Combined popliteal and posterior cutaneous nerve of the thigh blocks for short saphenous vein stripping in outpatients: an alternative to spinal anesthesia. J Clin Anesth 1997;9:618-622.
38. Calvo R, Figueroa D, Arellano S, et al. Femoral nerve block in anterior cruciate ligament surgery; a prospective randomised trial. Rev Chil Ortop Traumatol 2016;57:14-19.
39. Muñiz M, Rodríguez J, Escudero JA, et al. Peripheral nerve blocks for surgical anesthesia and postoperative analgesia of the lower extremity. Rev Esp Anestesiol Reanim 2003;50:510-520.
40. Bajo Pesini R, del Cojo Peces E, Delgado García I, et al. Management of postoperative pain in knee arthroplasty/arthroscopy in Spain. Lack of anaesthetic department support. Rev Soc Esp Dolor 2010;17:89-98.
How to Cite
1.
Calderón-Ochoa F, Mesa-Oliveros A, Rincón-Plata G, Pinto-Quiñones I. Effectiveness and safety of exclusive spinal anesthesia with bupivacaine versus femoral sciatic block during the postoperative period of patients having undergone knee arthroscopy: systematic review. Colomb. J. Anesthesiol. [Internet]. 2019 Jan. 1 [cited 2024 Apr. 18];47(1):57-68. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/217
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Published
2019-01-01
How to Cite
1.
Calderón-Ochoa F, Mesa-Oliveros A, Rincón-Plata G, Pinto-Quiñones I. Effectiveness and safety of exclusive spinal anesthesia with bupivacaine versus femoral sciatic block during the postoperative period of patients having undergone knee arthroscopy: systematic review. Colomb. J. Anesthesiol. [Internet]. 2019 Jan. 1 [cited 2024 Apr. 18];47(1):57-68. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/217
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Section
Systematic review
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