Summary

Our experience demonstrates that LA in arthroscopies is a convincing alternative to other forms of anesthesia and should further be considered as gold standard anesthesia in knee arthroscopy.

Abstract

Introduction

Knee arthroscopy is the most common Orthopaedic minimally invasive surgical procedure which can be used as diagnostic procedure and also treat a wide range of knee injuries. General or spinal anesthesia has been the preferential method of anesthesia. There is relatively little data on local anesthesia (LA) in knee arthroscopies available on literature. The aim of this study is to assess the efficacy of LA in knee arthroscopies.

Purpose

Arthroscopy of the knee under LA is still considered inferior to other forms of anesthesia, perhaps because of fear of insufficient anesthesia or a bad patient experience. Our study aims to prove that Arthroscopic techniques in the knee like meniscal repair, synovectomy, debridement and chondroplasty can all be reliably performed with use of LA.

Methods

We performed a retrospective analysis of the efficacy of local anesthesia in patients undergoing knee arthroscopy under LA over a period of 5 years. The anesthetic routinely used Ropivacaine 10mg/ml intra-articular and Xylocaine 2% percutaneously at the portal site and Xylocaine spray 10mg/dose for surface anesthesia. You may also be given medicines that relax you. We evaluated pain during procedure and after the procedure by recording a Visual Analogue Score (VAS).

Results

522 patients in this period (01/2014-06/2022 have been performed under LA. Gender distribution was 69,2%, females 30,7% mean age 50,26 years (range 16–79). Meniscus surgery, debridement, loose bodies removal, chondroplasty, plica syndrome, lateral release-medial plication, removal soft tissue abnormalities, were the procedures that performed. The mean VAS was measured in 259 cases. During injection was 1.6 (SD 2) and during the procedure 0.8 (SD 1.7). There has been no complication reported related to LA. We have not encountered any type 1 allergic reactions. At 2 patients the procedure was postponed due to local anesthesia failed (1 technical mistake, 1 anxiety of the patient).

Conclusion

Our experience demonstrates that LA in arthroscopies is a convincing alternative to other forms of anesthesia and should further be considered as gold standard anesthesia in knee arthroscopy.