Department of Anaesthesia, Institute for Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital, Mölndal, SE 431 80 Gothenburg, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1656-60. doi: 10.1007/s00167-010-1266-2. Epub 2010 Sep 21.
Knee arthroscopy is one of most commonly performed day-case orthopaedic procedures, thus consuming huge medical resources. The aim of the present questionnaire survey was to study knee arthroscopy routines and practice.
An electronic web-based survey including questions around pre-, per- and postoperative routines for elective knee arthroscopy was send to all orthopaedic units associated to the Swedish Arthroscopic Society (n = 60).
Responses covering 37 centres out of 60 (response rate 62%) were returned. Preoperative radiograph routines varied considerable between centres; conventional radiograph varied between 5 and 100% and preoperative MRI between 5 and 80% of patients. General anaesthesia was the preferred intra-operative technique used in all centres (median 79% of patients), local anaesthesia with or without light sedation was used in all 28 out of the 37 centres responding (median 10% of cases) and spinal anaesthesia was used in 15 centres (median 5% of cases). Intra-articular local anaesthesia was provided in all but one of centres. Perioperative administration of oral NSAIDs was common (31 out 37), 6 centres (all teaching hospitals) did not routinely give pre- or postoperative NSAID. Analgesic prescription was provided on a regular base in 18 (49%) of centres; an NSAID being the most commonly prescribed. All but one centre provided written information and instruction at discharge. Referral to physiotherapy, prescribed sick leave and scheduled follow-up in the outpatient clinic diverged considerably.
Routines and practice associated to elective knee arthroscopy differed; however, no clear differences in practice were seen between teaching centres, general or local hospitals apart from a lower usage of NSAID for perioperative analgesia. There is an obvious room for further standardisation in the routine handling of patients undergoing elective arthroscopy of the knee.
膝关节镜检查是最常进行的日间骨科手术之一，因此消耗了大量的医疗资源。本问卷调查的目的是研究膝关节镜检查的常规和实践。
向所有与瑞典关节镜学会相关的骨科单位（n=60）发送了一项包含膝关节镜检查术前、术中和术后常规问题的电子网络调查。
共收到 60 个单位中的 37 个（应答率为 62%）的回复。各中心之间术前 X 线检查常规差异较大；常规 X 线检查在 5%至 100%之间，术前 MRI 在 5%至 80%之间。所有中心均采用全身麻醉作为首选术中技术（中位数为 79%的患者），所有 37 个中心中有 28 个（中位数为 10%的病例）采用局部麻醉加或不加轻度镇静，15 个中心采用脊髓麻醉（中位数为 5%的病例）。所有中心均提供关节内局部麻醉。围手术期给予口服 NSAIDs 在 31 个中心中很常见（37 个中心中的 31 个），6 个中心（均为教学医院）不常规给予术前或术后 NSAIDs。18 个中心（49%）定期开具止痛药处方；最常开的是 NSAIDs。除一个中心外，所有中心均在出院时提供书面信息和指导。向物理治疗师转诊、规定病假和安排门诊随访差异很大。
膝关节镜检查的常规和实践存在差异；然而，除了围手术期镇痛中 NSAIDs 的使用较低外，在教学中心、综合医院或专科医院之间，实践并没有明显的差异。在常规处理接受膝关节镜检查的患者方面，显然还有进一步标准化的空间。
