Patient-controlled bupivacaine infusion into the infrapatellar fat pad after anterior cruciate ligament reconstruction.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

The goal of the study was to determine the safety and analgesic efficacy of a patient-controlled infusion pump that dispenses bupivacaine extra-articularly to the infrapatellar fat pad after anterior cruciate ligament (ACL) reconstruction with ipsilateral bone-patellar tendon-bone autogenous graft. Prospective clinical study. Twenty-one consecutive patients were enrolled in the study. After surgery, the catheter of a bupivacaine infusion pump was implanted extra-articularly onto the infrapatellar fat pad. Ten patients were given infusion pumps with 50 mL of 0.5% bupivacaine to be self-administered for analgesia. Eleven patients were given infusion pumps with 50 mL of 0.25% bupivacaine. Opioid analgesics were available if patients were unable to control the pain solely with the bupivacaine pump. Historic controls consisted of 62 consecutive patients who underwent ACL reconstruction before study initiation. Patients recorded volumes of self-administered bupivacaine; also recorded were postoperative pain levels using a visual analog scale (VAS). Opioid analgesic usage was measured and compared with historic controls. Amount of bupivacaine infused and VAS recorded pain levels were not significantly different between the 0.5% and the 0.25% bupivacaine groups. Opioid analgesic usage was significantly reduced when the 0.5% bupivacaine group was compared with historic controls (mean mo

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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