Evaluation of local anesthesia of the knee for out patient arthroscopy

ABSTRACT

This study was conducted to evaluate the efficacy of local and intraarticular local anesthesia for knee arthroscopy. Thirty millilitres of 0.5% Bupivacaine with adrenaline 5 ug/ml was adminstered to fifty healthy out-patients with a mean age of 30.4 +/- 8.95 years. Surgery began after a mean time of 39.6 +/- 15,4 minutes, diagnostic arthroscopy was done on 18 patients, and 32 patients underwent arthroscopic menisectomy. Anesthesia was successful in every case of diagnostic arthroscopy and 87% of arthroscopic menisectomies. After arthroscopy, patients were randomized to one of two groups, one group received 10 cc saline and the other group received 5 mg morphine in 10 cc saline intraarticularly. Patients recorded their analgesic score at 2,4,6 and 24 hours. Visual analog pain scales [VAPS] were similar in both groups for the first 4 hours, and significantly less in the morphine group after 24 hours, the time to first analgesic after discharge was also longer in the morphine group. We conclude that intraarticular local anesthesia is satisfactory for out-patient arthroscopic surgery, and morphine 5 mg with bupivacaine can provide superior post operative analgesia