The range of knee surgery performed arthroscopically in the outpatient setting is increasing. Newer techniques, such as anterior cruciate ligament reconstruction, involve greater degrees of surgical trauma and thus greater pain. Managing this pain on an outpatient basis is challenging but essential to a successful and satisfactory patient experience. Contemporary pain management strategies employ pre-emptive, continuous, and multimodal regimens. This article reviews the physiology of pain and the pharmacology of pain management to establish a basis for these concepts of contemporary pain management. The article then reviews the current literature of analgesic strategies applied specifically to patients undergoing arthroscopic knee surgery. Finally, the authors present a review of their 5-year experience of managing pain using contemporary concepts after arthroscopically assisted anterior cruciate ligament reconstruction in an outpatient setting.
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