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Randomized Controlled Trial
Hamstring donor-site block: evaluation of pain control after anterior cruciate ligament reconstruction.
- Brandon D Bushnell, Gary Sakryd, and Thomas J Noonan.
- Harbin Clinic Orthopaedics and Sports Medicine, 330 Turner-McCall Blvd., Rome, GA 30165, USA. bbushnell@harbinclinic.com
- Arthroscopy. 2010 Jul 1;26(7):894-900.
PurposeThe purpose of this study was to evaluate the effectiveness of using a hamstring donor-site block in controlling postoperative pain levels after anterior cruciate ligament (ACL) reconstruction with autogenous hamstring graft.MethodsOver a 5-month period, 27 patients underwent ACL reconstruction with hamstring autograft. All patients received a preoperative femoral nerve block. Intraoperatively, these patients were randomly assigned to groups with and without a hamstring donor-site block. The block group received a 20-mL injection of 0.25% bupivacaine into the hamstring donor site through an arthroscopic shaver sleeve. Both groups received standard postoperative pain medications as needed. Postoperative pain scores were taken by use of a visual analog scale (VAS) and recorded immediately on arrival to the recovery room, at 1 hour after arrival, and at 2 hours after arrival.ResultsThere were 15 patients in the hamstring donor-site block group and 12 patients in the standard treatment group. For the block group, mean VAS scores were 3.20 +/- 2.54 on arrival, 2.80 +/- 1.61 at 1 hour, and 2.87 +/- 1.41 at 2 hours. For the standard treatment group, mean VAS scores were 5.50 +/- 1.62 on arrival, 6.08 +/- 1.56 at 1 hour, and 5.33 +/- 2.02 at 2 hours. The hamstring block group had statistically significantly lower mean VAS scores on arrival (P = .0118), at 1 hour (P = .0001), and at 2 hours (P = .0010). There were no complications in either group.ConclusionsInjection of the hamstring donor site with local anesthetic through an arthroscopic shaver sleeve showed a statistically significant improvement in postoperative pain levels in patients undergoing autogenous hamstring ACL reconstruction.Level Of EvidenceLevel III, retrospective comparative study.Copyright (c) 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
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