Do Timing of Injection and Status of the Suction Drain Effect Postoperative Pain Scores After Intra-articular Bupivacaine Injection in Arthroscopic ACL Reconstruction?

Öz

Purpose: The purpose of this study was to evaluate if the timing of the intra-articular local anesthetic injection and the status of the suction drain result in variable pain scores after ACL reconstruction.

Methods: Forty patients undergoing arthroscopic ACL reconstruction were randomized  into four groups. They received  20ml bupivacaine 0.25% intra-articularly. GroupI received the agent 20 minutes before the start of the operation(preemptive-PE), GroupII at the end of the operation with the suction drain opened(DO), in GroupIII drain was closed for 1 hour(DC). GroupIV didn't receive any intra-articular injection(CG-control). Visual analog scale (VAS) scores and additional analgesic requirements were recorded.

Results: At postoperative hour 2, PE had the lowest and CG had the highest VAS scores. At hour 4, with the same ranking, the difference in VAS scores reached a significance in favor of DC in comparison to DO group (p<0.05). At  hour 6, VAS scores of PE  and DC were statistically not different and lower than the other groups (p<0.05). At hour 12, PE and CG had higher VAS scores in comparison to the DC and DO groups. VAS scores were not different among groups at hour 24.
The interval to first analgesic requirement was significantly shorter in the CG and longer in the PE in comparison to the other two groups (P<0.001).

Conclusion:  Intra-articular bupivacaine injection at different stages of the operation yielded variable VAS scores at the postoperative period. Closing the drain after intra-articular injection resulted in an early onset analgesic effect without shortening the duration.

 

DOI: 10.3944/AOTT.2015.14.0294
This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.

Anahtar Kelimeler

• ACL reconstruction;bupivacaine;postoperative pain;drain;VAS scores.