The role of local anaesthesia in knee arthroscopy.

Abstract

In current times, knee arthroscopy is the most common orthopaedic procedure. Over the years, the preferential method of anaesthesia has been general or spinal anaesthesia. The use of local anaesthesia (LA) in knee arthroscopies has been mentioned in surprisingly few orthopaedic publications over the past few decades. This reflects the very moderate role of LA in general compared to other forms of anaesthesia, even though the majority of operations in orthopaedic practice can be regarded as minor procedures. The aim of this study is to assess the efficacy of LA in knee arthroscopies. We performed a retrospective analysis of the efficacy of local anaesthesia in patients undergoing knee arthroscopy under LA over a period of 5 years. The anaesthetic routinely used is Xylocaine 2% with adrenaline. We evaluated pain during procedure and after the procedure by recording a Visual Analogue Score (VAS). Over a 5 year period (07/2005-06/2010), 433 knee arthroscopies have been performed under LA. The male:female ratio was 52:48%, mean age 48 years (range 14-84). The mean VAS during injection was 1.8 (SD 2) and during the procedure 0.9 (SD 1.7). There has been no complication reported related to LA. We have not encountered any type 1 allergic reactions. Our experience demonstrates that LA in arthroscopies is a convincing alternative to other forms of anaesthesia and should further be considered as gold standard anaesthesia in knee arthroscopy.