Shortening Postanesthesia Recovery Time After an Epidural: Is It Possible?

You are assigned to anesthetize a patient for a knee arthroscopy that is scheduled for 30 minutes. The patient is a 38-yr-old man, weight 75 kg, height 6′0″, American Society of Anesthesiologists physical status 1. He is to go home the same day. He is terrified of having a general anesthetic and would like a regional block. The surgeon feels that a lidocaine infiltration of the knee joint will not give sufficient analgesia and suggests a spinal or an epidural block. Because your experience with a sciatic/femoral block is limited, you do not discuss this option with the patient. The patient is agreeable to an epidural or spinal, but states that he needs to be out of the hospital by 10 am. He is the first case of the day and you are seeing him at 7 am. You tell him that he may be in the recovery room for 2–3 h before being discharged from the hospital, as the recovery room staff has to follow standard criteria for discharge. You give him an epidural, which works fine. The surgery, commences at 7:35 am. Unfortunately, the surgery takes longer than anticipated, and the time of arrival in the recovery room is 8:30 am. On arrival in the recovery room, the patient is awake, cooperative, and with 66% motor block according to Bromage scales (1). (The scales state that inability to move toes, knees or hips equals 100% motor block; ability to move toes, but not knees equals 66% motor block; ability to partially move knees equals 33% motor block; and ability to fully move knees equals no motor block.)?


Recovery Room Motor Block Knee Arthroscopy Epidural Injection Epidural Block 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bromage PR. An evaluation of bupivacaine in epidural analgesia for obstetrics. Can Anesth Soc J 1069;16:46-56.CrossRefGoogle Scholar
  2. 2.
    Brock-Utne JG, Macario A, Dillingham MF, Fanton GS. Postoperative epidural injection of saline can shorten postanesthesia care unit time for knee arthroscopy patients. Regional Anesth Pain Med 1998;23:247-251.CrossRefGoogle Scholar
  3. 3.
    Johnson M, Burger G, Mushlin P, Arthur GR, Datta S. Reversal of bupivacaine epidural anesthesia by intermittent injections of crystalloid solutions. Anesth Analg 1990;70:395-399.PubMedGoogle Scholar
  4. 4.
    Gissen A, Covino B, Gregus J. Differential sensitivities of mammalian nerve fibers to local anesthetic agents. Anesthesiology 1980;53:467-474.CrossRefPubMedGoogle Scholar
  5. 5.
    Benson H, Gissen A, Strichartz G, Avram AJ, Cavino BG. The effect of polyethylene glycol on mammalian nerve impulses. Anesth Analg 1987;66:553-559.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Personalised recommendations