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. 2018 Mar 28;4(2):236-239.
doi: 10.1016/j.artd.2018.02.011. eCollection 2018 Jun.

Single-dose lidocaine spinal anesthesia in hip and knee arthroplasty

Nicholas B Frisch  1 , Brian Darrith  2 , Dane C Hansen  3 , Adrienne Wells  2 , Sheila Sanders  2 , Richard A Berger  2
Affiliations

Single-dose lidocaine spinal anesthesia in hip and knee arthroplasty

Nicholas B Frisch et al. Arthroplast Today. .

Abstract

Background: With the increasing interest in fast recovery and outpatient joint arthroplasty, short-acting local anesthetic agents and minimal narcotic use are preferred. Lidocaine is a fast-onset, short-duration local anesthetic that has been used for many years in spinal anesthesia. However, lidocaine spinal anesthesia has been reported to have a risk of transient neurologic symptoms (TNSs). The purpose of this study is to determine the safety and efficacy of single-dose lidocaine spinal anesthesia in the setting of outpatient joint arthroplasty.

Methods: We performed a prospective study on 50 patients who received lidocaine spinal anesthesia in the setting of outpatient hip and knee arthroplasty. All patients received a single-shot spinal injection, with 2% isobaric lidocaine along with titrated propofol sedation. We evaluated demographic data, length of motor blockage, time to ambulation, time to discharge readiness, patient-reported symptoms of TNS.

Results: Of the 50 patients studied, 11 had total hip arthroplasty, 33 total knee arthroplasty, 5 unicompartmental knee arthroplasty, and 1 underwent isolated polyethylene liner exchange in a total knee arthroplasty. The average total duration of motor blockade was 2.89 hours (range 1.73-5.17, standard deviation 0.65). Average time from postanesthesia care unit to return of motor function was 0.58 hours (range 0-1.5, standard deviation 0.48). None of the patients reported TNS.

Conclusions: Isobaric lidocaine spinal anesthesia appears to be a safe and effective regimen for outpatient hip and knee arthroplasty. All patients were discharged on the day of surgery with isobaric lidocaine spinal injection. There were no reports of TNSs.

Keywords: Anesthesia; Spinal; Total hip arthroplasty; Total knee arthroplasty; Unicompartmental knee arthroplasty.

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References

    1. Pugely A.J., Martin C.T., Gao Y., Mendoza-Lattes S., Callaghan J.J. Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty. J Bone Joint Surg Am. 2013;95(3):193. - PubMed
    1. Chang C.C., Lin H.C., Lin H.W., Lin H.C. Anesthetic management and surgical site infections in total hip or knee replacement: a population-based study. Anesthesiology. 2010;113(2):279. - PubMed
    1. Zaric D., Pace N.L. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Cochrane Database Syst Rev. 2009;(2):CD003006. - PubMed
    1. Hampl K.F., Schneider M.C., Thorin D., Ummenhofer W., Drewe J. Hyperosmolarity does not contribute to transient radicular irritation after spinal anesthesia with hyperbaric 5% lidocaine. Reg Anesth. 1995;20(5):363. - PubMed
    1. Hampl K., Steinfeldt T., Wulf H. Spinal anesthesia revisited: toxicity of new and old drugs and compounds. Curr Opin Anaesthesiol. 2014;27(5):549. - PubMed

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