A comparison of three regional anaesthesia techniques for outpatient knee arthroscopy

Abstract

Purpose: The purpose of this study was to compare intraoperative conditions and postoperative pain control of three peripheral 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 CO 2 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-in-1 nerve block, intraarticular lidocaine 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 variables tested. Considerable postoperative pain (VAS ≤5) was experienced by 20/54 (37%) patients. Conslusion: 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.