THE EFFICACY OF REGIONAL ANESTHESIA FOR OUTPATIENT ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Arthroscopically assisted anterior cruciate ligament (ACL) reconstruct ion is a common orthopaedic procedure. Until recently, the majority of these procedures have been performed on an inpatient basis. This retr ospective study evaluated 67 consecutive patients who underwent an art hroscopically assisted, autogenous bone-patellar ligament-bone ACL rec onstruction that was supervised by the same surgeon. General endotrach eal anesthesia was used for 36 patients and a femoral sciatic nerve bl ock was used in 31 patients. Only patients who underwent either isolat ed ACL reconstructions, or those combined with either medial or latera l meniscectomies, were included. No statistically significant differen ces in either the mean anesthesia time or operative time existed betwe en the general anesthesia and regional anesthesia groups. Patients rec eiving regional anesthesia did require a significantly longer recovery room stay than those who received general anesthesia. Most of the pat ients who received general anesthesia had inpatient procedures. In the general anesthesia group, 31 of 36 patients spent at least one night in the hospital. Three of 30 patients who received regional anesthesia required hospital admission. There were no differences between anesth esia-related complication between groups. The cost saving of performin g ACL reconstructions under regional anesthesia compared with general anesthesia was calculated to be $2,907 per case and predominantly refl ected the outpatient approach used in these cases. This study supports the use of femoral sciatic nerve block anesthesia as a safe and relia ble alternative to general anesthesia for patients undergoing outpatie nt ACL reconstruction. The use of this technique was not found to comp romise operating room efficiency. Patients receiving regional anesthes ia did require a slightly longer recovery room stay. ACL reconstructio n performed under regional anesthesia with same-day discharge was well tolerated by our patients and it provides a cost-efficient alternativ e to ACL reconstructions performed as inpatient procedures.