Intrarticular Analgesics Following Shoulder Arthroscopy: Comparison of Ropivacaine/Dexamethasone With Ropivacaine

Panigrahi, Ranajit; Mahapatra, Amita Kumari; Priyadarshi, Ashok; Palo, Nishit; Das, Dibya Singha; Biswal, Manas Ranjan; Ranjan, Manas

doi:10.14260/jemds/2015/135

Cited by 2 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four studies [9,10,28,29] reported data on time to first analgesic request, all of which were examining the intraarticular infiltration vs. control comparison. Compared with control, intra-articular infiltration prolonged the time to first analgesic request by 560 min (469 to 652; p < 0.001; I 2 = 18%).…”

Section: Resultsmentioning

confidence: 99%

“…Our literature search identified 1392 unique titles; of these, 23 records remained after initial title and abstract review. The full text review of the 23 records identified 15 that met the eligibility criteria [8–11, 27–37] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…All shoulder operations were completed under general anaesthesia. Eight trials compared intra‐articular infiltration vs. control [8–10, 27–29, 34, 37]; four compared intra‐articular infiltration vs. interscalene brachial plexus block [30, 31, 33, 35]; and three included both comparisons [11, 32, 36]. Intra‐articular infiltration was administered by the orthopaedic surgeon in all but two trials [32, 36] where the anaesthetist performed intra‐articular infiltration.…”

Section: Resultsmentioning

confidence: 99%

“…The full text review of the 23 records identified 15 that met the eligibility criteria [8][9][10][11][27][28][29][30][31][32][33][34][35][36][37] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Intra‐articular infiltration analgesia for arthroscopic shoulder surgery: a systematic review and meta‐analysis

et al. 2020

View full text Add to dashboard Cite

Summary Phrenic‐sparing analgesic techniques for shoulder surgery are desirable. Intra‐articular infiltration analgesia is one promising phrenic‐sparing modality, but its role remains unclear because of conflicting evidence of analgesic efficacy and theoretical concerns regarding chondrotoxicity. This systematic review and meta‐analysis evaluated the benefits and risks of intra‐articular infiltration in arthroscopic shoulder surgery compared with systemic analgesia or interscalene brachial plexus block. We sought randomised controlled trials comparing intra‐articular infiltration with interscalene brachial plexus block or systemic analgesia (control). Cumulative 24‐h postoperative oral morphine equivalent consumption was designated as the primary outcome. Secondary outcomes included visual analogue scale pain scores during the first 24 h postoperatively; time‐to‐first analgesic request; patient satisfaction; opioid‐related side‐effects; block‐related adverse events; and any indicators of chondrotoxicity. Fifteen trials (863 patients) were included. Compared with control, intra‐articular infiltration reduced 24‐h postoperative analgesic consumption by a weighted mean difference (95%CI) of −30.9 ([−38.9 to −22.9]; p < 0.001). Intra‐articular infiltration also reduced the weighted mean difference (95%CI) pain scores up to 12 h postoperatively, with the greatest reduction at 4 h (−2.2 cm [(−4.4 to −0.04]); p < 0.05). Compared with interscalene brachial plexus block, there was no difference in opioid consumption, but patients receiving interscalene brachial plexus block had better pain scores at 2, 4 and 24 h postoperatively. There was no difference in opioid‐ or block‐related adverse events, and none of the trials reported chondrotoxic effects. Compared with systemic analgesia, intra‐articular infiltration provides superior pain control, reduces opioid consumption and enhances patient satisfaction, but it may be inferior to interscalene brachial plexus block patients having arthroscopic shoulder surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The full text review of the 23 records identified 15 that met the eligibility criteria [8][9][10][11][27][28][29][30][31][32][33][34][35][36][37] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Intra‐articular infiltration analgesia for arthroscopic shoulder surgery: a systematic review and meta‐analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Compared with hyaluronic acid and saline, triamcinolone acetonide produced a faster reduction in pain after injection 4. Panigrahi et al studied the analgesic effect of dexamethasone with ropivacaine, and confirmed that the combined intra-articular group had significantly low pain scores 5. Therefore, a multimodal drug regime (ropivacaine, morphine, and triamcinolone acetonide) is regularly used after shoulder arthroscopy in our clinics.…”

Section: Introductionmentioning

confidence: 99%

<p>Effect of ketorolac in intra-articular injection analgesia for postoperative pain in patients undergoing shoulder arthroscopy: a pilot-controlled clinical study</p>

Xu¹,

Qu²,

Li³

et al. 2019

JPR

View full text Add to dashboard Cite

BackgroundTo date, a regional approach using local anesthetics has become a popular analgesic method for arthroscopy. The optimal postoperative analgesia method for shoulder arthroscopy is still debated.ObjectiveThis study was designed to evaluate the effect and safety of using ketorolac in combination with a multimodal drug regime (ropivacaine, morphine, and triamcinolone acetonide) after shoulder arthroscopy.MethodsA total of 60 patients were included in a pilot study and patients were randomized into an experimental group (n=30) and a control group (n=30). The following parameters were used to evaluate pain relief levels postoperatively: the Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, and 48 hours postoperatively, morphine consumption, and initial analgesic desired time. Complications were also recorded.ResultsExcept for 1 hour postoperatively, patients in the experimental group experienced lower VAS scores during the first 48 hours postoperatively (P<0.05). The VAS score in both groups increased after 3 hours postoperatively and peaked at 12 hours postoperatively (2.54±0.86 vs 3.25±1.18). The VAS scores on movement in the experimental group were lower than those in the control group at 24 or 48 hours postoperatively (P=0.004, 0.001). A total of 18 (60.0%) patients in the experimental group required no additional analgesia, compared with 10 (33.3 %) in the control group (P=0.035). The mean rescue analgesia was 11.40±5.56 mg in the experiment group, while 16.57±8.48 mg in the control group (P=0.016). The initial analgesic desired time was delayed significantly in the experimental group (16.50±14.57 hours vs 8.9±6.32 hours, P=0.000).ConclusionAdding ketorolac to intra-articular injection analgesia is a safe and effective method to improve pain relief after shoulder arthroscopy, and further prospective controlled trials are necessary to allow definite treatment recommendations.

show abstract

Intrarticular Analgesics Following Shoulder Arthroscopy: Comparison of Ropivacaine/Dexamethasone With Ropivacaine

Cited by 2 publications

References 10 publications

Intra‐articular infiltration analgesia for arthroscopic shoulder surgery: a systematic review and meta‐analysis

Intra‐articular infiltration analgesia for arthroscopic shoulder surgery: a systematic review and meta‐analysis

<p>Effect of ketorolac in intra-articular injection analgesia for postoperative pain in patients undergoing shoulder arthroscopy: a pilot-controlled clinical study</p>

Contact Info

Product

Resources

About