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Postoperative Epidural Injection of Saline Can Shorten Postanesthesia Care Unit Time for Knee Arthroscopy Patients
  1. John G. Brock-Utne, M.D., Ph.D.,
  2. Alex Macario, M.D., M.B.A.,
  3. Michael F. Dillingham, M.D. and
  4. Gary S. Fanton, M.D.
  1. From the Departments of Anesthesia, Health Research and Policy, and Functional Restoration (Division of Orthopedic Surgery), Stanford University Medical Center, Stanford, California.
  1. Reprint requests: John G. Brock-Utne, M.D., Ph.D., Department of Anesthesia, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305.


Background and Objectives The goal of this prospective, double-blind study was to ascertain if the postanesthesia care unit (PACU) stay of outpatients receiving epidural anesthesia for knee arthroscopy is decreased by injection of epidural saline at the end of the case.

Methods Twenty healthy patients undergoing knee arthroscopy received lumbar epidural anesthesia with 2% lidocaine. At the end of surgery, in a doubleblind design, group 1 patients (intervention group) received 20 mL 0.9% saline injected into the epidural catheter. Patients in group 2 (control group) had 1 mL 0.9% saline injected into the epidural catheter. In the PACU, the epidural catheter was removed, and motor block was assessed at 15-minute intervals according to the Bromage scale. Standard discharge criteria for our ambulatory surgery center were followed.

Results Patients who received 20 mL epidural 0.9% saline remained in phase I (intensive nursing) 83 ± 8 minutes compared with control patients who stayed 110 ± 8 minutes (P < .01). Nonmedical issues related to the unavailability of the patients transportation or waiting for medications to be issued from the pharmacy delayed discharge from phase II (non-nursing) in 70% of group 1 patients and 60% of group 2 patients. Time to actual hospital dismissal for group 1 was 119 ± 14 minutes, compared with 159 ± 13 minutes (P < .05) for group 2.

Conclusion Patients receiving epidural anesthesia for knee arthroscopy had a shorter PACU stay if they received an injection of saline into the epidural space at the end of surgery.

  • epidural anesthesia
  • outcome
  • postanesthesia care unit
  • knee arthroscopy.

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  • This study was presented in part at the 1995 American Society of Anesthesia meeting in Atlanta, Georgia.