Journal List > J Korean Orthop Assoc > v.27(7) > 1114420

Song, Kim, Hur, and Lee: Knee Arthroscopy Under Intraarticular Injection of Bupivacaine


Arthroscopic surgery of the knee under local anesthesia has several advantages comparing to operation under spinal or general anesthesia. Besides, local anesthesia can be applied to almost every kind of arthroscopic procedures of the knee. Local anesthetics currently used in arthroscopic surgery are bupivacaine, lidocaine and prilocaine and variety of their usage and dosage have been reported(5,9,10) Among 245 cases of arthroscopic surgery of knee, 55 underwent operation under local anesthesia with bupivacaine in the Department of Orthopedics, Chonnam University Hospital, between Jan. 1990 and Apr. 1992. There were 37 males and 18 females. Twenty cases were young adults between 20 and 29 years of age. 10-30ml(Bupivacaine Hcl: 25-75mg) of 0.25% bupivacaine mixed with epinephrine (1: 200,000) were injected into the knee joint. The portals of entry were infiltrated with 8-20ml(Lidocaine Hcl: 80-200mg) of the mixture of 1% lidocaine and epinephrine (1: 200,000). The operation begun 26 minutes (8-50min) after intraarticular injection in average. The operations were meniscus surgery in 35, synovial surgery in 10, arthroscopic debridement in 5 and miscellaneous in 5. The average time of operation was 29.8 minutes (7-81min). Fifty patients cooperated well (excellent: 25, good: 25) during surgery but five patients did not do well(poor: 2) because of intermittent muscular contraction or pain. Three cases needed no analgesic medication postoperatively. In 52 cases, one ampule of Lopenac (Diclofenac Sodium 75mg) was injected intramuscularly for pain control. The average postarthroscopic analgesic time was 5 hours and 18 minutes (1 hour to 24 hours). The relationship between the dosage of bupivacaine and analgesic time was various in each patient. The complications such as cardiac toxicity and CNS effects which were related to bupivacaine or lidocaine were not detected. In summary local anesthesia using intraarticular injections of bupivacaine for arthroscopic surgery of knee is considered as a good procedure which is safe, simple and effectively applicable.

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