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Is knee arthroscopy under local anaesthetic a patient-friendly technique? A prospective controlled trial

  • Original Article • KNEE - ARTHROSCOPY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To determine that when the patient chooses their intervention, whether there is any difference in duration of surgery, effectiveness, patient satisfaction and recovery time between two methods of anaesthesia, local anaesthetic (LA) and general anaesthesia (GA) in knee arthroscopy (KA).

Methods

Inclusion criteria were medically fit, adults, undergoing unilateral KA, in a native knee as a day case. Exclusion criteria were requirement for ligament reconstruction or meniscal repair, pre-existing regional sensory impairment or active psychiatric condition. A prospective comparator controlled trial was conducted. The experimental group received local anaesthetic into the joint and no tourniquet. This was compared to a standard treatment, using GA with tourniquet. The LA group received 40 ml of anaesthetic consisting of 20 ml 0.5 % bupivacaine with adrenaline and 20 ml of 1 % lignocaine with adrenaline. Pre- and postoperative visual analogue score were completed, and patient’s satisfaction was assessed using a scale of one to five. Operative and recovery time was recorded.

Results

There was a significant decrease in recovery time for the LA group, 14 min 55 s, compared to 72 min 25 s (p = 0.004). Pain levels in the LA group were significantly decreased compared to the GA group. No failures of LA resulting in conversion to GA; no difference in patient satisfaction between the two groups 4.88/5 in the GA group and 4.81/5 in the LA group. 48 patients joined the LA group, and 34 patients joined the GA group. Both groups displayed similar demographic variables and underwent similar intraarticular interventions.

Conclusion

When patients undergoing KA choose their method of anaesthesia, LA is a reliable option. Use of LA results in decreased recovery time and postoperative pain, with similar levels of patient satisfaction when compared to GA.

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Acknowledgments

The authors thank Kerrie Ann, Maxine, Bev, Leanne, Molly and Bec from BOSMC for their assistance during various phases of this study.

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Authors and Affiliations

  1. Bendigo Orthopaedic and Sport Medicine Clinic, Bendigo, VIC, Australia

    Sergio Barroso Rosa & Dugal James

  2. Orthopaedic Research Institute of Queensland (ORIQL), Townsville, QLD , Australia

    Sergio Barroso Rosa & Brent David Matthews

Authors
  1. Sergio Barroso Rosa
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  2. Dugal James
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  3. Brent David Matthews
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Corresponding author

Correspondence to Sergio Barroso Rosa.

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Conflict of interest

Sergio Barroso has received research grants from Arthritis Australia (AOA Fellowship grant). Dugal James and Brent Mathews declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No specific ethical committee permission was applied for, as: (1) All patients signed a consent form to voluntarily participate in the study. (2) Both treatment options (LA and GA) are accepted routine anaesthetic modalities offered for patients in our practice. (3) All patients were offered both options, and it was an individual free choice of the patient to be included in either group. They received the same surgical treatment regardless of the chosen alternative. (4) As an analytic (not interventional) study, this research did not involve any change in the treatment standards of our practice. (5) Patients did not incur extra costs or received discounts in their medical fees for participating in the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Barroso Rosa, S., James, D. & Matthews, B.D. Is knee arthroscopy under local anaesthetic a patient-friendly technique? A prospective controlled trial. Eur J Orthop Surg Traumatol 26, 633–638 (2016). https://doi.org/10.1007/s00590-016-1799-2

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  • DOI: https://doi.org/10.1007/s00590-016-1799-2

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