| Abstract [eng] |
The aim of study. The aim of this study was to retrospectively evaluate perioperative outcomes and compare the impact of anesthesia choice in patients undergoing knee arthroscopy in a day surgery setting. Subjects and Methods. Patients who underwent knee arthroscopy due to meniscal tear at the Day Surgery Department of the Republican Vilnius University Hospital between 2009 and 2024 were included in the study. The analysis focused on cases in which the following types of anesthesia were used: general anesthesia with a laryngeal mask airway, spinal anesthesia with hyperbaric bupivacaine, low-dose spinal anesthesia, spinal anesthesia with isobaric bupivacaine, femoral and sciatic nerve block, femoral, sciatic, and obturator nerve block, femoral and sciatic nerve block combined with general anesthesia with a laryngeal mask airway, and femoral nerve block combined with general anesthesia with a laryngeal mask airway. The following anonymized patient data were collected: demographic information, ASA classification, comorbidities and current medications, doses of anesthetics and analgesics, need for vasoactive drugs during anesthesia, amount of fluid infusion, hemodynamic parameters during anesthesia, and postoperative analgesia requirements and strategy. Patients were divided into groups based on the anesthesia method applied. The collected data were analyzed, and perioperative outcomes were statistically compared between anesthesia groups. Results. A total of 121 patients were included in the study, with a mean age of 47.5 ± 12.96 years. The physical status of 92.6% of patients was classified as ASA class 1–2. The median duration of surgery was 35 [10–115] minutes. The lowest intraoperative opioid doses were administered in the spinal anesthesia groups. The greatest deviations from baseline systolic blood pressure and heart rate were recorded in patients who underwent general anesthesia, while the smallest deviations were observed during peripheral nerve blocks. After surgery, 26 out of 121 patients were monitored in the postoperative care unit. In total, 36 patients received opioids for postoperative pain management, most frequently after spinal anesthesia with isobaric bupivacaine. The only recorded anesthesia- related complication was postoperative nausea and vomiting, which occurred in 1.65% of cases. Only 31 patients were discharged home on the same day after surgery. Conclusions. Different anesthesia methods used during knee arthroscopy have varying effects on patients' hemodynamic stability, the quality of intraoperative analgesia, the need for postoperative pain management, and the length of hospitalization. The smallest hemodynamic fluctuations were observed during peripheral nerve blocks, while the most effective intraoperative analgesia was achieved with spinal anesthesia. The lowest need for postoperative analgesics was recorded in patients who received general anesthesia combined with femoral nerve block, and the highest proportion of same-day discharges was observed in the groups that received general anesthesia or spinal anesthesia with hyperbaric bupivacaine. Keywords: Choice of anesthesia, knee arthroscopy, day surgery, perioperative outcomes. |
