Purely intra-articular versus general anesthesia for proposed arthroscopic partial meniscectomy of the knee: a randomized controlled trial.
OBJECTIVE
The aim of this study was to compare intra-articular anesthesia alone versus general anesthesia with regard to ease of the procedure, level of postoperative pain, and patient satisfaction when partial meniscectomy is anticipated.


METHODS
We prospectively randomized to general anesthesia or to intra-articular anesthesia 107 patients who were about to undergo knee arthroscopy, in whom partial meniscal resection was anticipated on the basis of clinical or radiologic grounds. Technical difficulty of the procedure, level of postoperative pain and nausea, and overall patient satisfaction were assessed.


RESULTS
The ease of obtaining arthroscopic views, the adequacy of these views, and the ease of performing partial meniscal resection or another procedure were similar in both groups according to scores assigned by the operating surgeon. Pain at 6 hours postoperatively was significantly less in the intra-articular anesthesia group but was similar in the 2 groups at 24 and 48 hours. Patients who were given intra-articular anesthesia reported higher satisfaction rates in understanding the underlying disease of the knee.


CONCLUSIONS
We propose that intra-articular anesthesia alone can be effectively used in knee arthroscopies in which partial meniscal resection is anticipated.


METHODS
Level I, high-quality randomized controlled therapeutic trial.
Charalambous
Charalambos P
CP
Department of Orthopaedics, Manchester Royal Infirmary, Manchester, England. bcharalambos@hotmail.com
Tryfonidis
Marios
M
Alvi
Farhan
F
Kumar
Raj
R
Hirst
Philip
P
D000328:Adult; D015760:Alfentanil; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001182:Arthroscopy / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005283:Fentanyl; D006801:Humans; D007258:Informed Consent; D007270:Injections, Intra-Articular; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D018579:Patient Selection; D015742:Propofol; D015203:Reproducibility of Results; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome
D000779:Anesthetics, Local; D015760:Alfentanil; D005283:Fentanyl; D002045:Bupivacaine; D015742:Propofol; D004837:Epinephrine