Is knee arthroscopy under local anaesthetic a patient-friendly technique? A prospective controlled trial

To determine that when the patient chooses their intervention, whether there is any difference in duration of surgery, effectiveness, patient satisfaction and recovery time between two methods of anaesthesia, local anaesthetic (LA) and general anaesthesia (GA) in knee arthroscopy (KA).

Inclusion criteria were medically fit, adults, undergoing unilateral KA, in a native knee as a day case. Exclusion criteria were requirement for ligament reconstruction or meniscal repair, pre-existing regional sensory impairment or active psychiatric condition. A prospective comparator controlled trial was conducted. The experimental group received local anaesthetic into the joint and no tourniquet. This was compared to a standard treatment, using GA with tourniquet. The LA group received 40 ml of anaesthetic consisting of 20 ml 0.5 % bupivacaine with adrenaline and 20 ml of 1 % lignocaine with adrenaline. Pre- and postoperative visual analogue score were completed, and patient’s satisfaction was assessed using a scale of one to five. Operative and recovery time was recorded.

When patients undergoing KA choose their method of anaesthesia, LA is a reliable option. Use of LA results in decreased recovery time and postoperative pain, with similar levels of patient satisfaction when compared to GA.