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Analgesia after ACL reconstruction: Hamstring donor-site injection versus intra-articular local anaesthetic injection.

Authors
  • Sonnery-Cottet, B1
  • Saithna, A2
  • Azeem, A3
  • Choudja, E3
  • Pic, J B3
  • Cabaton, J3
  • Thaunat, M3
  • 1 Centre Orthopédique Santy, FIFA Medical Center of Excellence, Ramsay-Générale de Santé, Lyon, France. Electronic address: [email protected] , (France)
  • 2 Southport and Ormskirk Hospitals NHS Trust, Lancashire, United Kingdom. , (United Kingdom)
  • 3 Centre Orthopédique Santy, FIFA Medical Center of Excellence, Ramsay-Générale de Santé, Lyon, France. , (France)
Type
Published Article
Journal
Orthopaedics & Traumatology Surgery & Research
Publisher
Elsevier
Publication Date
Apr 01, 2017
Volume
103
Issue
2
Pages
235–238
Identifiers
DOI: 10.1016/j.otsr.2016.11.011
PMID: 28040578
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The purpose of this study was to compare hamstring donor-site injection versus intra-articular injection of a local anaesthetic for analgesia after anterior cruciate ligament (ACL) reconstruction. The two methods provide similar pain relief. 158 consecutive patients undergoing ACL hamstring tendon graft reconstruction (semi-tendinosus/gracilis [STG] or four-stranded semi-tendinosus [ST4]) during two periods in 2015 were included. Peripheral nerve block was not performed. At the end of surgery, 20mL of ropivacaine 7.5mg/mL was injected, intra-articularly during the early period (n=79) and into the hamstring donor site during the second period (n=79). Post-operative pain was evaluated subjectively by the patients using a visual analogue scale (VAS). We recorded patient demographics, concomitant surgical procedures, VAS pain scores, rescue analgesic use, time to discharge, and patient satisfaction. VAS pain score, side effects, and patient satisfaction were also recorded during a phone interview on the day after surgery (D1). Mean VAS pain scores were not significantly different between the two groups immediately after surgery (D0) or on D1 (D0: intra-articular, 2.08 and donor site, 1.88; Mann-Whitney P=0.6). Neither were the groups significantly different for rescue analgesic use, patient satisfaction, or quadriceps activation. The same local anaesthetic provides similar pain relief when injected intra-articularly or into the hamstring donor site after hamstring tendon ACL reconstruction (STG or ST4). III, prospective case-control study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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