Hamstring donor-site block: evaluation of pain control after anterior cruciate ligament reconstruction.
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of using a hamstring donor-site block in controlling postoperative pain levels after anterior cruciate ligament (ACL) reconstruction with autogenous hamstring graft.


METHODS
Over a 5-month period, 27 patients underwent ACL reconstruction with hamstring autograft. All patients received a preoperative femoral nerve block. Intraoperatively, these patients were randomly assigned to groups with and without a hamstring donor-site block. The block group received a 20-mL injection of 0.25% bupivacaine into the hamstring donor site through an arthroscopic shaver sleeve. Both groups received standard postoperative pain medications as needed. Postoperative pain scores were taken by use of a visual analog scale (VAS) and recorded immediately on arrival to the recovery room, at 1 hour after arrival, and at 2 hours after arrival.


RESULTS
There were 15 patients in the hamstring donor-site block group and 12 patients in the standard treatment group. For the block group, mean VAS scores were 3.20 +/- 2.54 on arrival, 2.80 +/- 1.61 at 1 hour, and 2.87 +/- 1.41 at 2 hours. For the standard treatment group, mean VAS scores were 5.50 +/- 1.62 on arrival, 6.08 +/- 1.56 at 1 hour, and 5.33 +/- 2.02 at 2 hours. The hamstring block group had statistically significantly lower mean VAS scores on arrival (P = .0118), at 1 hour (P = .0001), and at 2 hours (P = .0010). There were no complications in either group.


CONCLUSIONS
Injection of the hamstring donor site with local anesthetic through an arthroscopic shaver sleeve showed a statistically significant improvement in postoperative pain levels in patients undergoing autogenous hamstring ACL reconstruction.


METHODS
Level III, retrospective comparative study.
Bushnell
Brandon D
BD
Harbin Clinic Orthopaedics and Sports Medicine, 330 Turner-McCall Blvd., Rome, GA 30165, USA. bbushnell@harbinclinic.com
Sakryd
Gary
G
Noonan
Thomas J
TJ
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology / Q000637:transplantation*; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology; D010166:Palliative Care / Q000592:standards*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014182:Transplantation, Autologous; D055815:Young Adult
D000779:Anesthetics, Local; D002045:Bupivacaine