Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleEvaluation of postoperative bupivacaine infusion for pain management after anterior cruciate ligament reconstruction
Section snippets
Methods
In this study, 49 consecutive patients who prospectively enrolled were randomly assigned to 1 of 3 groups after ACL reconstruction. The randomization process was a random number draw conducted in the operating suite by a circulating nurse, and the group assignment and patient identification were recorded in a separate sealed notebook. Group 1 (control group) received no catheter, group 2 (placebo group) received an infusion catheter with saline, and group 3 (experimental group) received the
Results
The 3 groups were well matched with regard to age, gender, and affected side TABLE 1, TABLE 2. Of the 42 patients remaining, none experienced readmission, infection, wound complications, excessive swelling, or bupivacaine toxicity.6 No significant differences were found in tourniquet times or recovery room medications given to patients.
Discussion
Outpatient ACL reconstruction has improved overall patient satisfaction and allowed earlier return to work or athletic competition.7 In addition, the reduced consumption of hospital resources may save between $3,000 and $5,0008, 9 in costs per case. Although outpatient management of ACL reconstruction has been shown to be safe,7, 10 postoperative pain management continues to be a challenge. One series reported a repeat admission rate as high as 6.1% for problems with pain control.11
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