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Methods: After ethics committee approval and informed consent, 40 patients undergoing knee arthroscopy were studied. The patients were allocated either to receive intratechal 2ml (10mg) 0.5% bupivacaine + 25 μg fentanyl + 0.5 ml isotonic NaCl (Group BF, n = 20) or 1ml (10mg) 1% ropivacaine + 25 μg fentanyl + 1.5ml isotonic NaCl (Group RF, n = 20) in a randomly double blind fashion. In all the patients, dural puncture was performed with 27-gauge pencil point spinal needle at L3-4 intravertebral space in lateral decubitus position.
The time when the sensory block reached to the level of L1 was determined at the onset of action. Bromage scale (0-3) was used to evaluate the intensity of motor block. Onset and offset times and duration for motor and sensory blockades, spread of analgesia to maximum dermatom, first ambulatory and urination time, hemodynamic parameters were recorded. After discharge, advers effects were assessed by phone at postoperative 48 hour. Student t Test, Mann-Whitney U Test, Χ2 Test were used for statistical analyses, p < 0.05 was considered significant.
Results: The two groups were similar with respect to age, gender, weight and height. Onset time for motor blockade was shorter (4.23 ± 1.3 min) (p = 0.009) but the duration of motor blockade was longer (218.66 ± 54.52 min) (p = 0.001) in group BF than in group RF (8.50 ± 6.89 min, 204.25 ± 24.29 min). Onset time for sensory block was shorter in group BF but the results were not statistically significant (BF = 4.14 ± 2.39 min, RF = 5.25 ± 2.04 min). Offset time of sensory block to L1, first ambulatory and first urination time were longer in group BF (145.9 ± 42.42 min, 345.61 ± 131.61 min, 357.80 ± 140.99 min) than in group RF (99.56 ± 42.42 min, 262.62 ± 117.50 min, 261.81 ± 96.31 min) (p < 0.05). Changes of hemodynamic parameters and side effects were similar between groups.
Conclusion: We showed that ropivacaine + fentanyl has a shorter duration of motor and sensory block and the ambulation, urination and discharge times were also shorter.
