Effects of local anesthesia on recovery after outpatient arthroscopy

The effects of intraarticular bupivacaine administration on postoperative pain and mobilization were evaluated in 97 healthy outpatients undergoing knee arthroscopy under general anesthesia. After completion of the operation, which was performed using a standardized general anesthetic technique, the patient's knee was injected with 30 mL of either 0.5% bupivacaine or saline solution (control), according to a randomized, double-blind protocol. Although there were no statistically significant differences in the patient's assessment of postoperative pain, patients receiving bupivacaine required significantly less opioid analgesic medication in the postoperative period. More importantly, ambulation occurred more rapidly in those patients treated with bupivacaine (versus saline solution), permitting them to be discharged earlier than the control patients (145 +/- 51 min vs 173 +/- 50 min). No adverse effects were noted after the 150-mg intraarticular dose of bupivacaine. On the day after operation, no differences in physical activity or analgesic requirements were detected between the two treatment groups. In conclusion, bupivacaine reduced the opioid requirements and facilitated earlier mobilization after knee arthroscopy without altering the patients' perception of postoperative pain.