OUTCOME ANALYSIS IN POSTTRAUMATIC ANTERIOR CRUCIATE LIGAMENT INJURY: REVIEW OF PAIN AND RECOVERY POST SURGICAL MANAGEMENT
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Abstract
Anterior cruciate ligament (ACL) injuries are frequent among young, active individuals and often necessitate surgical reconstruction for optimal functional recovery, yet effective postoperative pain management remains a major clinical challenge. This prospective, randomized, controlled study evaluated the impact of a multimodal analgesic regimen—comprising intravenous lidocaine and magnesium sulfate as adjuncts to standard fentanyl-based analgesia—on postoperative pain control, opioid requirements, and short-term functional recovery in 90 ASA I–II patients aged 16 to 50 years undergoing elective arthroscopic ACL reconstruction with peroneus longus tendon autografts. Patients were randomly assigned to receive either fentanyl alone, fentanyl with lidocaine, or fentanyl with both lidocaine and magnesium sulfate. Pain was assessed at 30 minutes, 6 hours, and 18 hours postoperatively using the Visual Analog Scale (VAS), while functional and psychological outcomes were evaluated at six weeks using the IKDC, KOOS, and ACL-RSI scoring systems.
Patients receiving both lidocaine and magnesium sulfate with fentanyl demonstrated significantly lower postoperative pain scores at all assessed intervals, a reduced need for rescue opioid analgesia, and superior IKDC, KOOS, and ACL-RSI scores at six weeks, indicating enhanced early functional and psychological recovery. No delays in anesthetic emergence or adverse effects were associated with the multimodal analgesic regimen. These findings suggest that the addition of intravenous lidocaine and magnesium sulfate to conventional opioid analgesia provides a safe, effective strategy for improving postoperative outcomes after ACL reconstruction, supporting broader implementation of multimodal pain management protocols in knee ligament surgery.
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Dr. Nalluri Akhil
Post Graduate, Department of Orthopedics, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research (Deemed to be University) , Kanchipuram, Tamil Nadu, India
Dr Rajadurai
Professor , Meenakshi Medical College Hospital and Research Institute Kanchipuram, Tamil Nadu, India.
Dr Thulasi Raman
Professor and HOD, Meenakshi Medical College Hospital and Research Institute Kanchipuram, Tamil Nadu, India.
Dr Soni Neel
Post Graduate (Meenakshi Medical College Hospital and Research Institute Kanchipuram, Tamil Nadu, India.)
Dr Hari Kishore
Post Graduate (Meenakshi Medical College Hospital and Research Institute Kanchipuram, Tamil Nadu, India.)