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BJA Advance Access published online on December 25, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen357
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2009. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Plain articaine or prilocaine for spinal anaesthesia in day-case knee arthroscopy: a double-blind randomized trial

M. P. Hendriks1,*, C. J. M. de Weert1, M. M. J. Snoeck1, H. P. Hu2, M. A. L. Pluim3 and M. J. M. Gielen4

1 Department of Anesthesiology
2 Department of Orthopaedic Surgery
3 Department of Hospital Pharmacy, Canisius Wilhelmina Hospital, PO Box 9015, 6500 GS Nijmegen, The Netherlands
4 Department of Anesthesiology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

* Corresponding author. E-mail: m.snoeck{at}cwz.nl

Background: Both prilocaine and articaine are short-acting local anaesthetics suited for spinal anaesthesia for day-case knee arthroscopy. Articaine is thought to have a faster onset and shorter duration of action than prilocaine, although no comparative study has been published in the anaesthetic literature.

Methods: In this prospective randomized double-blind study, spinal anaesthesia was performed in 72 ASA I–II patients undergoing knee arthroscopy with 50 mg of either plain prilocaine or plain articaine. The primary outcome variable was duration of motor block. Secondary outcomes were onset of sensory and motor blocks, maximum spread of the sensory block, time to spontaneous voiding, and side-effects.

Results: Time to full motor function recovery was shorter after articaine than prilocaine [mean (SD) 140 (33) vs 184 (46) min, respectively, P<0.001]. Time to spontaneous voiding was shorter after articaine than prilocaine [mean (SD) 184 (39) vs 227 (45) min, respectively, P<0.001]. One patient in the articaine group reported mild transient neurological symptoms (TNS) limited to the first postoperative day, but there were no significant differences in adverse effects between the groups.

Conclusions: Spinal anaesthesia with plain articaine 50 mg resulted in a faster recovery of motor function and earlier spontaneous voiding compared with plain prilocaine 50 mg. Surgical anaesthesia was not different. The incidence of TNS was low.

Keywords: anaesthetic techniques, subarachnoid; anaesthetics local, articaine; anaesthetics local, prilocaine; surgery, day-case


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Some remarks and questions on the use of articaïne or prilocaïne
Chris van Velzen, et al.
British Journal of Anaesthesia, 1 Apr 2009 [Full text]

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