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Background: During recent three decades, parallel to the improvement of arthroscopic
techniques, intra-articular block by direct injection of anesthetics into the
joint has been used in
knee arthroscopy. In this study the efficacy of intra- articular block by
complex of bupivacaine, lidocaine and adrenaline in knee arthroscopy has been
assessed.
Methods: Forty one healthy adults (age range: 18-55
years) with knee problems selected for diagnostic arthroscopy. Anesthesia was
induced by direct injection of 10ml 2%
bupivacaine, 10ml 0.5%
lidocaine plus 1/100000 adrenaline into the
knee joint. Duration of operation and
volume of serum used for irrigation during the procedure pain and analgesics requirement,
during and after arthroscopy VAS (Visual
Analogue Scale)
score, at time of discharge from recovery and also patient's and surgeon's
satisfaction were assessed.
Results: Sixty eight percent and 29% of cases reported
mild and moderate degree of pain perception during arthroscopy, respectively,
and only one case for which general anesthesia was performed, reported severe
pain. VAS mean was 2.78.
Seventy eight percent of cases and the surgeon in 80%
of procedures had excellent or good satisfaction with intra-articular block.
Conclusions: Considering
high level of satisfaction in both patients and surgeon and mean of VAS,
complications of other modalities of anesthesisa and simplicity of the
technique, intra-articular block can be used as an easy, safe and efficient
method for knee arthroscopy.
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