Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
-
Randomized Controlled Trial Comparative Study Clinical Trial
Bupivacaine use after knee arthroscopy: pharmacokinetics and pain control study.
Bupivacaine (Marcaine) pharmacokinetics were determined in 11 patients receiving the drug intraarticularly after arthroscopic procedures performed on the knee with patients under general anesthesia. Forty milliliters of 0.25% bupivacaine (100 mg) were given as a bolus into the intraarticular space of the knee of each patient. The thigh tourniquet was released 2-3 min after injection and blood samples were obtained 5, 10, 15, 20, 30, 60, 120, 180, 250, and 300 min after tourniquet release. ⋯ Peak levels can be minimized with shorter tourniquet inflation times and with longer injection to tourniquet release intervals. Ninety healthy adult outpatient knee arthroscopy patients also were studied to evaluate the effectiveness of bupivacaine in relieving postoperative knee discomfort when injected immediately postoperatively. The subjects were randomized into four groups: (a) intraarticular injection of saline, (b) intraarticular injection of bupivacaine, (c) subcutaneous injection of bupivacaine at the portal sites, and (d) both intraarticular and subcutaneous injection of bupivacaine.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Case Reports
Acute pulmonary edema, an unusual complication following arthroscopy: a report of three cases.
Acute pulmonary edema in the young athlete is a rare complication following arthroscopic surgery. It is not related to fluid absorption during arthroscopy, but rather to a brief period of upper airway obstruction. ⋯ Young athletes may be at increased risk for laryngospasm-induced pulmonary edema because they have the ability to generate large negative intrathoracic pressures. This condition must be recognized promptly to minimize morbidity and mortality.
-
We describe two patients who had pain of unknown cause in the right hip for many years. Plain roentgenograms results were normal, and arthrography did not reveal any abnormal findings. Because clinical examinations strongly suggested internal derangement of the hip, arthroscopies of the hips were performed. ⋯ Partial limbectomies were performed by the posterior approach, and the patients showed marked decrease in hip pain postoperatively. This report shows that a solitary lesion of fibrocartilaginous tissue of the hip can cause hip pain. These conditions can be easily misdiagnosed as sciatica.
-
The course of the suprascapular nerve and its distance from fixed scapular landmarks were measured in 90 cadaveric shoulders. In an additional 15 cadavers, three pins were passed at various angles in a general anterior-posterior direction through the middle of the glenoid neck just inferior and lateral to the base of the coracoid process. The distance between the exit site on the posterior glenoid neck and the suprascapular nerve at the base of the scapular spine was recorded for each pin. ⋯ On the basis of these data, a relative safe zone is described in the posterior glenoid neck. Knowledge of the anatomic course of the suprascapular nerve may aid the physician in the diagnosis and treatment of suprascapular neuropathies. Appreciation of the safe zone may help the shoulder surgeon avoid iatrogenic injury to the suprascapular nerve during arthroscopic Bankart procedures and other open surgical procedures requiring dissection of the posterior glenoid neck.