Although shivering is one of the consequences of perioperative hypothermia and is rarely considered as the most serious complication, it occurs frequently and remains poorly understood. While cold-induced shivering has an obvious etiology, post-general anesthetic shivering is attributed to numerous causes. Until now, dexamethasone has been used for the treatment of post-general anesthetic shivering. The objective of the present study is to evaluate the effects of intravenous dexamethasone on the prevention of post-general anesthetic shivering. Patients and 80 patients who were candidates for elective knee arthroscopic surgery were selected and randomly divided into case and control groups. Immediately after the induction stage of anesthesia, which was the same for both groups, 0.15 mg/kg of intravenous dexamethasone was administered to the case group. The same amount of distilled water was intravenously administered as placebo to the control group. The temperature of the operating room was kept between 20 and 25 degrees centigrade. When the operation ended, shivering score was measured and recorded by a trained nurse in the recovery room. The patients and the nurse were blind to case and control allocation of the patients. The mean age of the patients, the temperature difference between operating room and patient's body, and shivering score were 27.34 years, 9.52 degrees centigrade and 1.76 respectively. Both groups were matched for age, weight, operating room and patient's body temperature difference, surgery time, recovery time, and the amount of administered fluids. There were statistically significant differences in score and incidence of shivering between the two groups. A statistically significant correlation was also found between administered fluid volume and shivering score in both groups. The obtained results revealed that intravenous dexamethasone is effective in the prevention of post-general anesthetic shivering. This confirms previous studies and it seems that this study supports central mechanism of post-general anesthetic shivering rather than peripheral one.

Arthroscopic knee surgery is a painful operation and control of its pain causes earlier recovery of the patients. Therefore, the reduction of the post-operative pain is very important. The aim of this study was to evaluate the analgesic effect of intra-articular ketamine injection after knee arthroscopy. In a double blind randomized study, 75 patients with age ranging of 18-60 years who were candidate for elective arthroscopy were chosen and the same anesthetic method was used for all of them. Based on the injected anesthetic drug, they were divided into five equal groups, A-E. Group A received both intra-articular ketamine (0.5 mg/kg) and intravenous placebo. Group B received intra-articular ketamine (0.75 mg/kg) and intravenous placebo. Group C received intravenous ketamine (0.5 mg/kg) and intra-articular placebo. Group D received intravenous ketamine (0.75 mg/kg) and intra-articular placebo. Group E received intravenous and intra-articular placebo. After the operation, if necessary, intra-veouns morphine (0.05 mg/kg) was given for pain relief. Using visual analogue scale (VAS 1 to 10), the pain was evaluated at 4, 8 and 24 hours after the operation. The time of first rescue analgesic request, and the total dose of morphine used was recorded. Statistical analysis was carried out by using SPSS software. The results of this study showed that there was no significant difference in the cases of age, sex, weight and duration of operation among 5 groups studied. Also, the total amount of opioid or the time beginning of analgesic request was not statistically different among the groups during 24 hours observation. Based on our results, intra-articular ketamine injection did not reduce postoperative pain after diagnostic knee arthroscopy and had no sparing effect on total opioid consumption and first postoperative analgesic request.

Accuracy of different methods of magnetic resonance imaging for detection of knee lesions is still questionable. This study was aimed to compare the accuracy of intraarticular contrast enhanced magnetic resonance arthrography and intravenous contrast enhanced magnetic resonance arthrography for detection of knee lesions. Twenty five patients who had knee lesions and candidated for diagnostic and treating arthroscopy were entered to the study. The intraarticular contrast enhanced MR and intravenous contrast enhanced MRI has been performed for them. The results of imaging has compared with findings of arthroscopy as a gold standard for calculation of each test sensitivityand specificity and the overall accuracy of each method. The calculated sensitivity, specificity and overall accuracy for intraarticular contrast enhanced in respect for MM is 87%, 100%, 88% and LM 77%, 91%, 84% and ACL 84%, 100%, 88% and PCL 88%, 93%, 92% and about the intravenous contrast enhanced in respect for MM is 48%, 100%, 52% and LM 0%, 100%, 44% and ACL 84%, 100%, 88% and PCL 30%, 100%, 72%. Comparing of overall accuracy of 2 methods has shown that replacement of intravenous contrast enhanced MR for intraarticular contrast enhanced MR is just acceptable for ACL and PCL lesions (P=1.000, P=0.063). We demonstrated that the overall accuracy of intravenous contrast enhanced MR for detecting of ACL and PCL lesions is comparable with intraarticular enhanced MR and both methods could be used as each other.

Postoperative Deep Vein Thrombosis (DVT), a subtype of Venous Thromboembolism (VTE), is a significant preventable cause of morbidity and mortality worldwide. VTE is estimated to occur at a rate of one per 1,000 people per year, with DVT accounting for approximately two-thirds of these events. DVT continues to be a common complication of knee arthroscopy. The purpose of this study is to determine the prevalence of DVT in patients who have undergone arthroscopic knee surgery.

Patients over the age of 18 years who underwent arthroscopic knee surgery in a teaching hospital were evaluated for VTE clinically and via lower limb Doppler ultrasonography prior to, three days after, and four weeks after surgery. The incidence of DVT was determined and associated with risk factors such as age, sex, duration of immobility, and duration of surgery. Afterward, statistical analysis was performed on the data.

The prevalence of DVT was 3.1% in 318 patients undergone knee arthroscopy with a mean age of 34.31 years. The mean duration of surgery was 96.30 minutes across all patients. In 96.9% of patients, there was no evidence of DVT. Additionally, there was no significant association between DVT prevalence and gender, age, surgery type, duration of surgery, or presence of edema in patients (p = 0.551). The patients' mean duration of absolute rest was 61.89 hours. Absolute rest time was significantly longer in patients with positive DVT than in patients with negative DVT (p = 0.001).

While knee arthroscopy can be performed as an outpatient procedure, the risk of postoperative DVT is unknown. The incidence of DVT following arthroscopic knee surgery was 3.1% in this study, a necessary precondition for perioperative thromboprophylaxis.

Aim and Our goal to perform this study was to evaluate the effect of adding lidocaine to the irrigation solution during knee arthroscopy on decreasing patient''s degree of pain. Methods and materials: This was a randomized double blind study، in which 41 patients were enrolled in each group. In the control group، the irrigation solution in arthroscopy was just normal saline without any adjuvant. However in our cases، the solution contained 0. 5 mg per ml lidocaine. The patients were compared according to their degree of pain and opioid request in the ward up to 6 hours thereafter. The visual analogue pain scale showed that the score of pain was significantly decreased in the case group in comparison with the control one. Moreover، the patients in the case group had significantly less request for opioids after arthroscopy. Adding lidocaine to the irrigation solution in knee arthroscopy could be an effective method to lower the degree of pain in patients.

IntroductionThe knee is one of the most frequently injured joints. Clinical tests in the diagnosis of meniscus and ligament injuries have limitations and it may not be possible to elicit objective signs repeatedly. MRI, has been shown to improve diagnostic accuracy in many knee disorders. Its principal attractiveness over arthroscopy is that it is noninvasive. To determine the effectiveness of magnetic resonance imaging in the appropriate identification of traumatic intra articular knee lesions, we compared its findings with clinical examination and arthroscopy as a gold standard technique in a descriptive cross sectional study.Materials and MethodsOverall 100 patients with knee trauma were entered and completed the study. All patients had thorough clinical examination By experienced physicians. An MRI of the affected knee was requested in all patients. Arthroscopies were performed for all of them. ResultsOverall 55 knees were reported to have ACL tear arthroscopically, Meniscal injuries were found in 75 cases. We found correlation between posterior drawer test, MRI report of PCL tear and arthroscopic PCL tear. The sensitivity of MRI for detecting Meniscal tear: represented high, for bucket handle tear of medial meniscus, and high specificity for Lateral meniscal tear.ConclusionIt is concluded that arthroscopy still remains the gold standard technique. More powerful MRI scan equipments with better soft wares will be needed in order to have much better diagnosis.

During recent three decades, parallel to the improvement of arthroscopic techniques, intra-articular block by direct injection of anesthetics into the joint has been used in knee arthroscopy. In this study the efficacy of intra- articular block by complex of bupivacaine, lidocaine and adrenaline in knee arthroscopy has been assessed. Forty one healthy adults (age range: 18-55 years) with knee problems selected for diagnostic arthroscopy. Anesthesia was induced by direct injection of 10ml 2% bupivacaine, 10ml 0.5% lidocaine plus 1/100000 adrenaline into the knee joint. Duration of operation and volume of serum used for irrigation during the procedure; pain and analgesics requirement, during and after