Abstract
Objective To evaluate postoperative pain, using the visual analog scale (VAS), in patients
undergoing anterior cruciate ligament reconstruction (ACLR) and receiving intra-articular
anesthetic solutions.
Methods The present is a randomized clinical trial with a sample of 48 patients divided into
4 groups: Group I (n = 12) – 20 mL of saline solution (control); Group II (n = 12)
– 20 mL of 0.5% bupivacaine; Group III (n = 12) – 20 mL of 0.5% bupivacaine + 0.1 mg
of epinephrine; and Group IV (n = 12) – 20 mL of saline solution + 0.1 mg of epinephrine.
These solutions were injected into the knee at the end of the surgery. Pain was assessed
using the VAS immediately and 6, 12, 24 and 48 hours after the procedure.
Results The VAS scores were highly variable among the groups. A Kruskal-Wallis analysis of
variance (ANOVA), considering a level of significance of 5%, revealed that all intra-articular
anesthetic solutions influenced the assessment of pain (p = 0.003), and that Group-III subjects presented less postoperative pain. There was
no evidence of a higher or lower use of supplemental analgesic agents, or of adverse
effects resulting from these anesthetic solutions.
Conclusion Bupivacaine combined with epinephrine was the most effective solution for pain control
in patients undergoing ACLR, but with no statistically significant differences when
compared to Group II (p = 0.547). There was no decrease or increase in the use of supplemental analgesics
or in the occurrence of adverse systemic effects (p > 0.05).
Keywords anterior cruciate ligament - pain assessment - analgesia - drug therapy - arthroscopy
