Abstract
Introduction: Knee arthroscopy under LA, has been shown to be reliable and safe. However, this is not a widely practiced method for knee arthroscopy in the UK. A number of studies have compared various types of anaesthesia with a specific knee pathology. The aim of this study was to compare various anaesthesia techniques, and determine for LA cases the ease of the procedure, level of perioperative pain, patient satisfaction and outcome, in a non homogenous population.
Materials and Methods: We prospectively studied a group of 116 consecutive patients undergoing knee arthroscopy. The choice of LA and GA was given to the patient, the decision for Spinal was made by the anesthetist. Time for each method, surgical access, peri-operative pain and patient satisfaction was studied. Patients undergoing arthroscopy for suspected instability had GA.
Results: 97 patients had the surgery performed under LA, 6 had SA and 19 had GA. Patients undergoing arthroscopy under LA understood the disease process better. 86/97 patients of the LA group did not complain of any pain/discomfort. 8 patients required further sedation for completion of the procedure. 2 patients had a possible vaso-vagal attack and needed monitoring. Surgical access was good in all patients with LA. A variety of procedures could be carried out including partial meni-sectomy, chondroplasty and microfracture in 2 patients. Immediate post-operative pain score: 0 in 92/97. Overall patient satisfaction: good in 89/ 97. There were more complications in the Spinal and GA group.
Conclusion: Arthroscopy of the knee performed under local anesthesia is a safe, practical and, possibly economical alternative to conventional anesthesia. It can be done in most routine knee arthroscopic surgery.
Correspondence should be addressed to: Tim Wilton, BASK, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
