A prospective study of pain and analgesic use in outpatient endoscopic anterior cruciate ligament reconstruction.

A prospective study was undertaken to evaluate the postoperative pain and analgesic profiles of a group of 50 patients undergoing outpatient anterior cruciate ligament (ACL) reconstruction and to compare their profiles with those of a group of 50 patients undergoing outpatient non-ACL arthroscopic surgery. All patients received preoperative and postoperative ketorolac, intraincisional/intra-articular bupivacaine, intraoperative ketorolac, and propofol anesthetic. The percentage of patients receiving supplemental analgesia in the recovery room was 49% (average, 2.2 mg intravenous morphine sulfate) for the ACL group and 31% (average, 1.2 mg intravenous morphine sulfate) in the non-ACL group. Narcotic use and pain scores peaked in both groups on postoperative days 1 and 2. The ACL group used significantly more narcotic and had higher pain scores in the first week after surgery than did the non-ACL group. However, there were no subsequent admissions, readmissions, or emergency room visits for pain. All were satisfied with the outpatient nature of this surgery. Patients tolerate outpatient endoscopic ACL reconstruction with moderate pain and narcotic use. Outpatient endoscopic ACL reconstruction can be performed safely, effectively, and with considerable cost savings.