PAIN RELIEF AFTER ARTHROSCOPIC SURGERY OF THE KNEE - A PROSPECTIVE, RANDOMIZED, AND BLINDED ASSESSMENT OF BUPIVACAINE AND BUPIVACAINE WITH ADRENALINE

A prospective, randomized, and double-blind study was conducted to compare the influence on postoperative pain of equal volumes of saline, bupivacaine, or bupivacaine with adrenaline, injected both intraarticularly and into the wound puncture site, for 118 day case patients undergoing elective knee arthroscopy. Marginal analyses of postoperative visual analogue pain scores and postoperative fentanyl doses showed that the group given bupivacaine with adrenaline had less postoperative pain when compared with the saline group. However, when multifactor analyses were performed, preoperative visual analogue pain scores, operation type and length, and the sex of the patient were all shown to be significant predictors of postoperative pain, but the use of bupivacaine was not. We conclude that the observed differences in postoperative pain were due to differences between the groups in these predictive factors, especially preoperative pain scores, and that the use of bupivacaine was less important and not statistically significant in influencing postoperative pain.