Ankle arthroscopy is a minimally invasive surgical procedure that allows doctors to diagnose and treat a variety of conditions affecting the ankle joint. This procedure often requires anesthesia to manage pain during and after surgery. Traditionally, general or spinal anesthesia is used. However, a recent study has explored the use of preemptive local anesthesia in combination with general or spinal anesthesia to enhance pain management and speed up recovery.
The study, conducted from January 2014 to February 2016, involved 80 patients who underwent anterior ankle arthroscopies. The patients were randomly assigned to one of four groups, each receiving a different type of anesthesia: general and local preemptive, spinal and local preemptive, general and placebo, or spinal and placebo. Preemptive local anesthesia involves administering a local anesthetic before the surgical procedure to help manage postoperative pain.
After receiving general or spinal anesthesia, each patient was given an injection of either a mixture of local anesthetics or a normal saline solution (placebo). The researchers then measured the patients’ pain levels at various intervals after the release of the tourniquet using a visual analog scale (VAS), a common tool used to measure pain intensity. They also noted the use of additional painkillers and any adverse effects.
The results of the study were promising. The groups that received preemptive local anesthesia (groups A and B) experienced significantly less pain in the first 24 hours after surgery. Until 8 hours after the release of the tourniquet, the pain intensity level was statistically lower in the groups A, B, and D compared to group C (general anesthesia and placebo). Moreover, none of the patients from groups A and B required on-demand ketoprofen, a type of painkiller, intravenously during their hospital stay.
In terms of safety, no side effects from the local anesthetic agents were observed. However, two patients experienced temporary numbness and paresthesia (a sensation of tingling or prickling) in the area of sensory nerve innervation of the dorsal intermediate cutaneous nerve of the foot. This suggests that while the procedure is generally safe, there may be minor, temporary side effects in some cases.
In conclusion, the study found that preemptive operative site infiltration with a mixture of local anesthetics in ankle arthroscopy was a safe procedure that effectively reduced postoperative pain and the need for additional painkillers. This approach could potentially improve patient comfort and accelerate recovery time, making it a valuable addition to the current anesthesia options for ankle arthroscopy.
It’s important to note that this study is a Level I, prospective randomized study, which is the highest level of evidence in medical research. This means the results are highly reliable and could potentially influence changes in clinical practice. However, as with any medical procedure, the choice of anesthesia should be tailored to the individual patient’s needs and circumstances, taking into account factors such as their overall health, the specific condition being treated, and their personal preferences.
To read the full journal article, head to http://feedproxy.google.com/~r/FootAnkleInternational/~3/h35ssMllMSk/1326