Postarthroscopy analgesia with bupivacaine

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Abstract
The analgesic effect of intraarticular bupivacaine in jected at the conclusion of knee arthroscopy done under general anesthesia was investigated in a pro spective, randomized, and blinded fashion. Pain scores, the use of analgesic medications, crutch use, weight bearing, activity level, and difficulty sleeping the night after surgery were all unaffected by the use of bupiva caine. The apparent lack of effect is most likely due to rapid clearance from the knee, leaving only a transient, 1 to 2 hours of potential benefit. In this study, the patients were already quite comfortable during this time period due to the routine use of intraoperative narcotics. The preoperative level of knee discomfort was found to be a major determinant of postoperative discomfort. Other much less important factors were synovial and chondral shaving, sex of the patient, and experience of the surgeon.