Wallace D A, Carr A J, Loach A B, Wilson-MacDonald J
Nuffield Orthopaedic Centre, Headington, Oxford.
Ann R Coll Surg Engl. 1994 Sep;76(5):330-1.
A prospective study of the effectiveness of local anaesthesia in arthroscopy of the knee was performed in 212 consecutive patients. Arthroscopic surgery was undertaken successfully in 121 cases (57%), including meniscectomy and drilling of osteochondral defects. Dynamic evaluation of the patellofemoral joint articulation was possible and demonstration of pathological abnormalities was felt to be beneficial by some patients. The method described is safe, reliable, confers good postoperative analgesia and enables physiotherapy to begin immediately. Conversion to general anaesthesia was necessary in one case due to pain localised to a stiff and osteoarthritic hip. Intra-articular haemorrhage was found to be a problem in one case with synovitis. Only ten patients complained of moderate pain, none had severe pain. Local anaesthesia is contraindicated in cases with ipsilateral osteoarthritis of the hip or with significant synovitis of the knee. This technique is particularly suited to day case surgery.
对212例连续患者进行了局部麻醉在膝关节镜检查中有效性的前瞻性研究。121例（57%）成功进行了关节镜手术，包括半月板切除术和骨软骨缺损钻孔术。对髌股关节活动进行动态评估是可行的，一些患者认为显示病理异常是有益的。所描述的方法安全、可靠，术后镇痛效果良好，并能立即开始物理治疗。1例因僵硬且患骨关节炎的髋关节局部疼痛而需要转为全身麻醉。1例滑膜炎患者出现关节内出血问题。只有10例患者主诉中度疼痛，无严重疼痛病例。同侧髋关节骨关节炎或膝关节有明显滑膜炎的病例禁忌使用局部麻醉。该技术特别适用于日间手术。
