Single-dose lidocaine spinal anesthesia in hip and knee arthroplasty

Single-dose lidocaine spinal anesthesia in hip and knee arthroplasty

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Background: With the Baby Oil 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 CARDANA CAPS 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.