Abstract
Purpose
The purpose of this study was to compare intraoperative conditions and postoperative pain control of three penpheral regional anaesthesia techniques for outpatient knee arthroscopic procedures.
Methods
Sixty patients were randomized to one of three groups. Group IA received portal injections (10 ml lidocaine 1%), intraarticular lidocaine (20 ml CO2 lidocaine 2% with 1/200.000 adrenaline) and a placebo femoral nerve block (20 ml saline). Group FNB received a femoral 3-in-1 nerve block (20 ml chloroprocaine 2% with 1/200.000 adrenaline), placebo portal injections (10 ml saline) and placebo intraarticular saline (20 ml saline with 1/200.000 adrenaline). Group FNB + IA received a femoral 3-m-1 nerve block, intraarticular hdocaine and placebo portal injections. The following were assessed: intraoperative pain (10 cm VAS: 0 = no pain. 10 = extreme pain), surgical operating conditions (1 = excellent. 4 = unacceptable), intraoperative use of sedation and analgesia, time to discharge, patient satisfaction score (1= very satisfied, 5 very unsatisfied) and postoperative analgesia. Data were analyzed using ANOVA, Kruskal-Wallis, and Chi-square tests as appropriate. P< 0.05 was considered significant.
Results
There were no differences among the groups regarding any of the vanables tested. Considerable postoperative pain (VAS> 5) was expenenced by 20/54 (37%) patients.
Conclusion
Any of the three anaesthetic techniques tested provide reliable intraoperative patient and surgical conditions for outpatient knee arthroscopy. Patient discomfort postoperatively was considerable in all groups and requires further investigation.
Résumé
Objectif
Cette étude visait à comparer les conditions peropératoires et l’analgésie postopératoire procurées par trois techniques périphériques d’anesthésie régionale administrées pour une chirurgie arthroscopique du genou chez des patients ambulatoires.
Méthodes
Soixante patients étaient répartis aléatoirement en trois groupes. Le groupe IA recevait des injections portales (10 ml lidocaïne 1%), de la lidocaïne mtra-articulaire (20 ml de lidocaïne CO2 adrénalinée à 1:200.000) et un bloc fémoral placebo. Le groupe FNB recevait un bkx fémoral 3 dans 1 (20 ml de chlorprocaïne 2% adrénalinée à 1:200 000). une injection portale placebo (10 ml de sol. phys.) et une injection articulaire placebo de sol. phys. (20 ml de sol. phys. adrénaline à 1:200 000). Le groupe FNB + IA recevait un bloc fémoral 3 dans 1. de la hdocaine intra-articulaire et des injections portales placebo. Les paramètres suivants étaient évalués: la douleur peropératoire (ÉVA 10 cm.0 = pas de douleur, 10 = douleur extrême), les conditions chirurgicales (1- excellentes. 4=inacceptables), l’utilisation peropératoine de sédation et d’analgésie, le score de satisfaction du patient (1 = très satisfait. 5 = très mécontent) et l’analgésie postopératoire. Les tests pertinents ANOVA, Kruskal-Wallis et chi au carré ont servi à l’analyse des données. P< 0,05 était considéré comme significatif.
Résultats
Il n’y a eu aucune différence au regard des vanables étudiées. Vingt patients sur 54 (37%) ont éprouvé une douleur postopératoire importante (ÉVA≥5).
Conclusion
Les trois techniques étudiées ont procuré des conditions opératoires favorables à une arthroscopie du genou tant pour le patient ambulatoire que pour le chirurgien. L’inconfort postopératoire était considérable et devrait susciter des études plus approfondies.
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Goranson, B.D., Lang, S., Cassidy, J.D. et al. A comparison of three regional anaesthesia techniques for outpatient knee arthroscopy. Can J Anaesth 44, 371–376 (1997). https://doi.org/10.1007/BF03014456
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DOI: https://doi.org/10.1007/BF03014456