Comparison of Postoperative Pain in Patients Undergoing Arthroscopic Repair by Spinal or General Anesthesia

Knee arthroscopy can be performed under general anesthesia and regional techniques such as spinal or local anesthesia. However, in recent years, spinal anesthesia has become more common because of faster recovery and greater comfort after surgery. After arthroscopy, an appropriate analgesia facilitates the recovery and returns the patients faster to the active status. Thus, we decided to compare length of analgesia, severity of pain, and duration of stay in recovery after knee arthroscopy using two techniques of spinal (with 5% lidocaine) and general (total intravenous) anesthesia. Materials and methods: In this clinical trial, 81 patients (ASA I-II) were included and randomly assigned to one of the groups of spinal (5% lidocaine) or total intravenous anesthesia (propofol and remifentanil). The postoperative pain was recorded by VAS pain score at the time intervals of 30 minutes, 1, 2, 6, 12, and 24 hours after the operation together with the duration of stay in recovery, duration of postoperative analgesia, first analgesic prescription, and total analgesic intake. All the collected data were analyzed in SPSS 20. Findings: In this study, the patients had not significant difference in terms of demographic characteristics. The mean duration of stay in recovery among the patients under ACL arthroscopic repair was 31.22 min in the spinal group and 35 min in the general group (P=0.002). The frequency distribution of opioid drugs and analgesics or, in general, the statistical difference between the spinal and general groups was not significant. In terms of mean duration of analgesia after the surgery (h) using Mann-Whitney U test, the patients had analgesia for 8.11 h after spinal anesthesia and 2.53 h after general anesthesia (P=0.0001);the statistical difference was quite significant. Discussion and conclusion: According to the findings of this study, it seems that the postoperative pain in the patients undergoing ACL arthroscopic repair with general anesthesia was higher and the duration of analgesia after the surgery was shorter. However, no significant difference was found in terms of total dose of analgesic consumed.