Effectiveness of Intra-Articular Ropivacaine for Post-Operative Analgesia in Arthroscopic Knee Surgeries

Abstract

BACKGROUNDPost-operative pain frequently hampers implementation of day care arthroscopic knee surgery in spite of so many analgesic, local anaesthetic drugs and routes of administration. The aim of this study was to evaluate the efficacy and safety of intraarticularly administered inj. ropivacaine 0.25% 20 ml, after arthroscopic knee surgery performed under spinal anaesthesia, for prolonging the duration of postoperative analgesia. METHODSThis is a prospective randomized study conducted among 80 patients of both sexes, of American Society of Anesthesiologists, physical status I and II, undergoing day care arthroscopic knee surgery who were randomly assigned into two groups (R, C). Group R received 20 ml of 0.25% ropivacaine, whereas group C received 20 ml of 0.9% inj. normal saline through intra-articular route at the end of the procedure. Pain was assessed using visual analog scale (VAS) and paracetamol given as rescue analgesic when VAS >4. Time of first analgesic request and total rescue analgesic were noted. RESULTSTime for the requirement of first post-operative rescue analgesia (255.15±26.35 vs. 92.40±12.54) min and total mean rescue analgesic requirement was (1.32±0.52 vs. 3.0±1.0) in group R and C respectively. Group C had higher mean VAS score throughout the study period. No side effects were found among the groups. These two results were clinically and statistically significant (p<0.05). CONCLUSIONSAdministration of intra-articular inj. ropivacaine 0.25%, 20ml, is effective & safe method of management of postoperative pain in patients undergoing arthroscopic knee surgeries, as it prolongs the duration of postoperative analgesia, provides better quality of analgesia with reduced requirement of rescue analgesia without significant side effects.

Analgesic Efficacy of Levobupivacaine Injected Intraarticularly Following Knee Arthroscopy

“…In the current study, the total 24 hrs postoperative diclofenac Na consumption was statistically significantly lower in levobupivacaine group when compared to control group. This is in accordance with Nagpure et al (12) who claimed that as compared to ropivacaine, intraarticular levobupivacaine provides superior postoperative pain relief, lengthens the period until the first analgesic request, and reduces the requirement for complete postoperative analgesia. Sahin et al (13) studied the adjuvant effect of intraarticular levobupivacaine used with IV dexketoprofenon on postoperative pain relief following knee arthroscopy.…”