The Journal of Bone and Joint Surgery 82:1754 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.
Pain Management in Patients Who Undergo Outpatient Arthroscopic Surgery of the Knee*
Scott S. Reuben, M.D. and
Joseph Sklar, M.D.
*No benefits in any form have been received or will be received
from a commercial party related directly or indirectly to the subject
of this article. No funds were received in support of this study.
Department of Anesthesiology, Baystate Medical Center, 759 Chestnut
Street, Springfield, Massachusetts 01199. E-mail address: scott.reuben@bhs.org.
New England Orthopedic Surgery, 300 Carew Street, Springfield,
Massachusetts 01104. E-mail address: jsklar@concentric.net.
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Introduction
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 Arthroscopy of the knee joint produces an initial afferent
barrage of pain signals that have the capacity to initiate prolonged
changes in the nervous system leading to the amplification and prolongation
of postoperative pain.
Preemptive analgesia involves the administration of analgesics
prior to painful stimuli to prevent the amplification of postoperative
pain.
It is currently recommended that multimodal analgesic regimens
be utilized in the management of postoperative pain.
Intra-articular bupivacaine and morphine are effective analgesics
for arthroscopic knee surgery.
Intra-articular ketorolac, corticosteroids, and clonidine may
also have a role in reducing pain following arthroscopic knee surgery.
Nonsteroidal anti-inflammatory drugs play an important role in
the management of postoperative orthopaedic pain, and the newer
cyclooxygenase-2-specific nonsteroidal anti-inflammatory drugs may
have additional advantages with respect to safety.
Preemptive and multimodal analgesic techniques should be utilized
in the management of patients undergoing anterior cruciate reconstruction.
Arthroscopy of the knee joint, including reconstruction of . . . [Full Text of this Article]
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