Abstract
Purpose
The purpose was to determine if the use of cold irrigation fluid in routine knee arthroscopy leads to a reduction in post operative pain.
Background
Some surgeons use cooled irrigation fluid in knee arthroscopy in the hope that it may lead to a reduction in post operative pain and swelling. There is currently no evidence for this, although there is some evidence to support the use of cold therapy post operatively in knee surgery.
Methodology
We conducted a blind randomised controlled trial comparing the use of cooled (4°C) and room temperature irrigation fluid in routine arthroscopic knee surgery.
Pain was recorded on a numerical scale (0 to 10) hourly for 3 hours post-operatively, at discharge and daily for 1 week. A detailed record of analgesic consumption was recorded.
Patients were randomised into the cooled group (mean age 50.1 years) and the room temperature group (mean age of 46.1 years).
Results
The average hourly difference in pain score for the first 3 hours post operatively was 0.12, 0.57, and 0.23 with reduced pain scores in the cooled fluid group, but this did not reach statistical significance.
Total analgesic administration in theatre, recovery and the ward was lower in the cooled fluid group, as was the self administration of analgesia for the week after discharge.
No increased complications where seen.
Conclusion
No significant difference in patient reported pain scores has been demonstrated after the use of cooled irrigation fluid in routine knee arthroscopy. The tendency to a slight reduction in analgesic consumption in the cooled fluid group may have more significant benefits in complex arthroscopic knee surgery such as ligament reconstruction, this requires further study.
