Arthroscopic Meniscectomy under Local Anesthesia

Abstract

Background: The knee arthroscopy is often performed under general or spinal anesthesia on an outpatient basis.The purpose of this study was to demonstrate how the most common arthroscopic procedures of the knee can be performed with the combination of IA and pericapsular injection technique. Methods: From January 2011 to December 2013, 300 patients underwent arthroscopic meniscectomy surgery under local anesthesia. These patients were compared with other 150 cases treated with GA during the same period. They were evaluated for clinical symptoms during surgery and at predetermined intervals after surgery (1, 4 and 24 h); pain scoring was performed at rest (VASr) and on mobilization (VASm). The post-operative use of paracetamol has been noted (g / day).The patients were evaluated at 3 months after surgery with the patient's personal satisfaction scale and information about the return to work and sporting activities.Every patient was assessed clinically 3 months after surgery. Results: According to the patients treated with local anesthesia, the median VAS pain score during surgery was 2,27; one hour postoperative during movement was 2,27, during rest was 2,02; four hours postoperative during movement was 2,98, during rest was 2,70; twenty-four hours postoperative during movement was 2,50, during rest was 2,28. The patients subjective satisfaction was sortable as excellent in 53,3% patients. 78% patients returned to previous sports within 2 months after the surgery. Conclusion: The use of local anesthesia in knee arthroscopic surgery allows a reduction of operating time, costs, and an earlier return to work and sport activities, without the need to increase the postoperative pain therapy compared with surgery in spinal anesthesia.