Arthroscopic Meniscectomy

Anesthesia Implications

Position: Supine, arms at side on armboards
Time: 30-60 min (short)
Blood Loss: Low (10-50 ml)
Post-op Pain: Moderate (3-6)
Maintenance Paralytic: No
Tourniquet Use: Yes

Tourniquet (general considerations): Antibiotics should be administered prior to tourniquet inflation. Tourniquet pain usually begins 45-60 minutes after inflation and is unresponsive to regional anesthesia and analgesics. Upper extremity pressure should be set to approximately 70-90 mmHg above systolic blood pressure (SBP). Lower extremity tourniquet pressure should be set to approximately 2 times SBP. Upon tourniquet release, there will be increases in End-tidal CO2 and metabolic acidosis, while decreases will be seen in core body temperature, blood pressure, and mixed venous oxygen saturation (SvO2)

The menisci are cartilages that sit between the tibia and femur. There is the medial and lateral meniscus. Either one can be torn or damaged with intense physical activity. Most commonly, this happens by a twisting motion. This injury is very common in patients participating in contact sports. Mild injury (Grade I or II) are typically treated with anti-inflammatory medications, rest, and possible physical therapy. More severe injuries (Grade III) typically require a partial or total meniscectomy.

Very often, this surgery is paired with a knee arthroscopy to determine the severity of the injury.

An arthroscopic procedure is done by making 3 small incisions around the knee. The scope is inserted into these incisions to examine the menisci. In some cases, only a small portion will be removed (partial meniscectomy), in other cases the menisci are completely removed (total meniscectomy). The incisions are then closed using sutures or surgical strips.