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Analgesia for Anterior Cruciate Ligament Reconstruction

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Controversies in the Technical Aspects of ACL Reconstruction

Abstract

Anterior cruciate ligament reconstruction produces moderate-to-severe postoperative pain. Primarily the femoral but also the sciatic nerve distribution may be affected, especially when a hamstring autograft is utilized. When compared to general anesthesia for ambulatory knee surgery, neuraxial anesthesia offers several advantages, including superior early pain control and reduced postoperative nausea and vomiting, but may result in urine retention or delayed discharge from the hospital in ambulatory settings. Multimodal pharmacologic approaches for postoperative analgesia should be utilized for complex joint procedures such as ACLR. Inclusion of peripheral nerve blockade, either in the form of femoral or adductor canal blockade, provides superior pain control to medications alone.

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Author information

Authors and Affiliations

  1. UPMC-Southside/Mercy Ambulatory Center, University of Pittsburgh School of Medicine, 2000 Mary Street, Pittsburgh, PA, 15203, USA

    Steven L. Orebaugh MD

  2. UPMC-Southside/Mercy and UPMC-East Anesthesia Service, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Michael L. Kentor MD

  3. Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy

    Battista Borghi

Authors
  1. Steven L. Orebaugh MD
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  2. Michael L. Kentor MD
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  3. Battista Borghi
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Corresponding author

Correspondence to Steven L. Orebaugh MD .

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Editors and Affiliations

  1. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

  2. Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Stefano Zaffagnini

  3. Hospital for Special Surgery, New York, New York, USA

    Robert G. Marx

  4. UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA

    Volker Musahl

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Orebaugh, S.L., Kentor, M.L., Borghi, B. (2017). Analgesia for Anterior Cruciate Ligament Reconstruction. In: Nakamura, N., Zaffagnini, S., Marx, R., Musahl, V. (eds) Controversies in the Technical Aspects of ACL Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52742-9_9

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  • DOI: https://doi.org/10.1007/978-3-662-52742-9_9

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