Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
-
Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, double-blind trial of pre-emptive local anesthesia in day-case knee arthroscopy.
The study goal was to assess the efficacy of pre-emptive analgesia in a clinical setting. ⋯ Prophylactic local anesthesia confers no statistically significant reduction in pain scores or perioperative general anesthetic requirements as compared with postoperative administration. The pre-emptive effect in clinical practice may be less dramatic than that observed in more controlled animal models. Further studies are required to investigate the magnitude of the pre-emptive effect in clinical practice.
-
Randomized Controlled Trial Clinical Trial
The efficacy of continuous bupivacaine infiltration following anterior cruciate ligament reconstruction.
The purpose of this study was to determine whether continuous infiltration of a local anesthetic into the surgical wound for 48 hours will diminish the need for narcotics and improve the postoperative pain experience for patients undergoing anterior cruciate ligament (ACL) reconstruction using a patellar tendon autograft. ⋯ This report of a new technique suggests that surgical knee patients receiving local anesthetic infusion postoperatively experience less pain and require less narcotics. The disposable pump allowed administration of the medication on an outpatient basis.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Subacromial and intra-articular morphine versus bupivacaine after shoulder arthroscopy.
Multiple studies have compared the effects of intra-articular bupivacaine and morphine for postoperative pain control after arthroscopy of the knee. To date, these agents have not been compared in the shoulder. The purpose of this study was to compare intra-articular (IA)/subacromial (SA) morphine, bupivacaine, and placebo after shoulder arthroscopy. ⋯ IA/SA morphine does not contribute to postoperative pain control after shoulder arthroscopy, whereas IA/SA bupivacaine improves pain control during the first 60 minutes after surgery.
-
Randomized Controlled Trial Clinical Trial
The effectiveness of an anesthetic continuous-infusion device on postoperative pain control.
To evaluate the effectiveness of an anesthetic continuous-infusion device on postoperative pain after outpatient shoulder surgery. ⋯ Postoperative pain control after arthroscopic shoulder surgery is essential so that these procedures can be successfully carried out in an outpatient setting. The first 2 postoperative days is the period of greatest pain. Continuous postoperative bupivacaine infusion is effective during this critical period, and the effect lingers even after the infusion is discontinued. The administration of bupivacaine via a continuous-infusion anesthetic pump statistically reduced postoperative pain after outpatient arthroscopic rotator cuff repairs, SLAP lesion repairs, subacromial decompressions, and capsular reefings.
-
Randomized Controlled Trial Clinical Trial
Arthroscopic shoulder surgery with epinephrine saline irrigation.
To determine whether dilute epinephrine saline irrigation (0.33 mg/L) delivered by a pressure-controlled pump would significantly reduce intraoperative bleeding during routine arthroscopic shoulder surgery and, in addition, to investigate potential adverse cardiovascular reactions of adding epinephrine to the irrigation fluid. ⋯ The addition of epinephrine to irrigation fluid seems to reduce intra-articular bleeding during routine arthroscopic shoulder surgery and may improve visualization. Furthermore, no cardiovascular adverse reactions were observed resulting from the intra-articular epinephrine administration.