title: A comparison of pain scores and medication use in patients undergoing single-bundle or double-bundle anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  No gold standard exists for the management of postoperative pain following anterior cruciate ligament reconstruction (ACLR). We compared the pain scores and medication use of patients undergoing single-bundle (SB) or double-bundle (DB) ACLR in the acute postoperative period. Pain and medication use was also analyzed for spinal versus general anesthesia approaches within both surgery types.
  
  
  METHODS
  We assessed 2 separate cohorts of primary ACLR patients, SB and DB, for 14 days postoperatively. We used a standard logbook to record self-reported pain scores and medication use. Pain was assessed using a 100 mm visual analogue scale (VAS). Medications were divided into 3 categories: oral opioids, oral nonsteroidal anti-inflammatories and acetaminophen.
  
  
  RESULTS
  A total of 88 patients undergoing SB and 41 undergoing DB ACLR were included in the study. We found no significant difference in VAS pain scores between the cohorts. Despite similar VAS pain scores, the DB cohort consumed significantly more opioid and analgesia medication (p = 0.011). Patients who underwent DB with spinal anesthesia experienced significantly less pain over the initial 14-day postoperative period than those who received general anesthesia (p < 0.001).
  
  
  CONCLUSIONS
  Adequate pain relief was provided to all ACLR patients in the initial postoperative period. Patients in the DB cohort experienced more pain, as evidenced by the significant diffrence in consumption of opioids and acetaminophen, than the SB cohort. Patients who underwent spinal anesthesia experienced less pain in the acute postoperative period than those who received general anesthesia.
authors.affiliation: Banff, Alta.
authors.forename: Simon A
authors.initials: SA
authors.lastname: Macdonald
authors.affiliation: The Banff Sport Medicine, Banff, Alta., and the Department of Surgery, University of Calgary, Calgary, Alta.
authors.forename: S M
authors.initials: SM
authors.lastname: Heard
authors.affiliation: The Banff Sport Medicine, Banff, Alta., and the Department of Surgery, University of Calgary, Calgary, Alta.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Hiemstra
authors.affiliation: The Banff Sport Medicine, Banff, Alta.
authors.forename: Gregory M L
authors.initials: GM
authors.lastname: Buchko
authors.affiliation: The Banff Sport Medicine, Banff, and the Department of Physical Therapy, University of Alberta, Edmonton, Alta.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kerslake
authors.affiliation: Sasyniuk Consulting, Vancouver, BC.
authors.forename: Treny M
authors.initials: TM
authors.lastname: Sasyniuk
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011182:Postoperative Care / Q000379:methods / Q000592:standards; D011785:Quality Assurance, Health Care; D057566:Self Report; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen