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  • Title: Pre- versus postoperative intraarticular application of local anesthetics and opioids versus femoral nerve block in anterior cruciate ligament repair.
    Author: Mayr HO, Entholzner E, Hube R, Hein W, Weig TG.
    Journal: Arch Orthop Trauma Surg; 2007 May; 127(4):241-4. PubMed ID: 16721618.
    Abstract:
    BACKGROUND: Often anterior cruciate ligament (ACL) reconstruction is performed as outpatient surgery. This requires a patient friendly postoperative pain management. Three common procedures were compared in this trial. METHODS: In a prospective, randomized study the effect of postoperative pain management using preoperative intraarticular anesthesia (0.1 mg Fentanyl + 8 ml Bupivacain 0.5%) was compared with postoperative intraarticular anesthesia (0.1 mg Fentanyl + 8 ml Bupivacain 0.5%) and the femoralis 3-in-1 nerve block (20 ml Prilocain 1% + 20 ml Bupivacain 0.5%) in 157 patients who underwent arthroscopic ACL-plasty. RESULTS: Preoperative intraarticular anesthesia and the femoralis 3-in-1 nerve block showed the same postoperative analgesia and satisfactory pain scores in most cases. Postoperative intraarticular anesthesia was less effective. CONCLUSION: Our data show that in anterior cruciate ligament reconstruction preoperative intraarticular analgesia with Bupivacain/Fentanyl is satisfactory and equal to the femoralis 3-in-1 nerve block with Bupivacain.
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