Hamstring donor-site block: evaluation of pain control after anterior cruciate ligament reconstruction.

Abstract

PURPOSE:

The 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.

METHODS:

Over 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.

RESULTS:

There 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.

CONCLUSIONS:

Injection 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 EVIDENCE:

Level III, retrospective comparative study.

• Authors: Brandon D Bushnell, Gary Sakryd, Thomas J Noonan
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 26 Issue 7 Pg. 894-900 (Jul 2010) ISSN: 1526-3231 [Electronic] United States
• PMID: 20620788 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright (c) 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anesthetics, Local
• Bupivacaine

Topics

• Adolescent
• Adult
• Anesthetics, Local (administration & dosage)
• Anterior Cruciate Ligament (surgery)
• Bupivacaine (administration & dosage)
• Female
• Femoral Nerve
• Humans
• Injections, Intramuscular
• Male
• Middle Aged
• Muscle, Skeletal (innervation, physiopathology, transplantation)
• Nerve Block
• Pain Measurement
• Pain, Postoperative (drug therapy, physiopathology)
• Palliative Care (standards)
• Plastic Surgery Procedures (methods)
• Transplantation, Autologous
• Young Adult