Local or spinal anesthesia in acute knee surgery.

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Knee arthroscopy is a common orthopedic procedure.
• Anesthesia choice impacts patient outcomes and recovery.
• Local anesthesia (LA) and spinal anesthesia (SA) are potential options.

Purpose of the Study:

• To compare the efficacy, safety, and complications of local anesthesia (LA) versus spinal anesthesia (SA) for knee arthroscopy.
• To evaluate intraoperative pain, patient satisfaction, and postoperative recovery.
• To determine the optimal anesthetic technique for outpatient knee arthroscopy.

Main Methods:

• A comparative study of 436 patients undergoing knee arthroscopy.
• Patients received either local anesthesia (n=250) or spinal anesthesia (n=186).
• Key outcomes included pain scores, surgical conditions, patient satisfaction, postoperative analgesia, and discharge time.

Main Results:

• Local anesthesia demonstrated superior intraoperative pain control (97.6% pain-free) and patient satisfaction.
• The local anesthesia group experienced significantly shorter postoperative stays and faster discharge (94% discharged within 2 hours vs. 68% for SA).
• Local anesthesia was associated with a significantly lower rate of complications compared to spinal anesthesia.

Conclusions:

• Local anesthesia is a simple, reliable, and safe alternative to spinal anesthesia for outpatient knee arthroscopy.
• LA offers benefits in terms of reduced pain, improved patient satisfaction, and faster recovery.
• LA is recommended for patients undergoing diagnostic or surgical knee arthroscopy with intraarticular disorders.