부분마취하 슬관절경 수술 - 장점 및 단점

Arthroscopy is a procedure for diagnosing and treating acute and chronic internal derangements of the knee joint, now its roles are more widening because of its advantage high accuracy of diagnosis, shortening of the recovery time. Especially introduc- tion of arthroscopic operation under the local anesthesia was possible to decrease side effects and complication by general anesthesia. We have experienced 369 cases of the intra-articular problems of the knee joint who were treated by arthroscopic operation from April 1989 to May 1991. Among them 165 cases which were treated by arthroscopic operation under local anesthesia were reviewed retrospectively. The results are as follows: 1. The patients ranged in age from 12 years to 83 years and 54 (33 %) patients were in third decade, 110 patients were men and male was affected 2 times more than female. 2. Time from injection of the local anesthetic to start of operation was average 38.6 minutes and consuming time during operatin was average 64.4 minutes. 3. The most common arthroscopic finding was meniscal lesions in 73 cases (me- dial 28, latera1 45), the next was osteoarthritis in 52 cases, and the third was ligament injury in 33 cases. 4. Under the local anesthesia the most common arthroscopic operation was partial meniscectomy in 58 cases, the next was synovectomy in 22 cases and the third was plica removal in 13 cases. 5. Arthroscopic operation was performed 104 cases in only local anesthetics-bupi- vacaine 100 mg + lidocaine 400 mg but for sedation during operation injected deme- rol and/or valium in 61 cases (37 %), 6. The side effect of local anesthesia during intra or postoperative period were temporal hypotension and bradycardia in 3 cases but recovered soon without sequehe. In conclusion, arthroscopy under the local anesthesia is considered a simple, safe, reliable procedure for patients in whom clinical examination suggests intra-articular disorders of the knee.