Intra-articular Bupivacaine versus Bupivacaine Dexamethasone for Analgesia after Knee Surgery plus
نویسندگان
1 •Assistant Professor of Anaestl1esiologv, urmia University of Medical Sciences, Urmia, Iran
2 ··Assistant Professor of Orthopaedics. Urmla University of Medical sciences, Urmia, Iran.
3 'Anaesthesiologist, urmia unrversitv of Medical Sciences, Urmia. Iran.
doi
چکیده
Background: Postoperative pain is a common problem suffering the patients after knee surgery. Treatment with intra articular corticosteroid preparation has been advocated but the value of this approach has not been established. We compared the efficacy of intra-articular dexamethasone plus bupivacaine with the efficacy of intra-articular bupivacaine alone to prevent post-operative pain after meniscectomy. Methods: Sixty ASAI patients undergoing meniscectomy with general anesthesia were randomly assigned to receive intra-operative intra-articular bupivacaine, bupivacaine plus dexamethasone, or placebo under double blinded condition. The goup 1 (n:::20) received 10ml of bupivacaine 0.5% with epinephrine 1:2000000, group 2 (n=20) received 8ml bupivacaine 0.5% with epinephrine 1:200000 plus 2ml (8mg) dexamethasone and group 3 (n:::20) received 10ml of normal saline. The patients were evaluated until 12 hours af1er the operation and pain levels at rest measured by a Visual Analogue Scale (VAS). Results: During the first six hours after the operation, both combination of bupivacaine and dexamethasone and bupivacaine alone significantly reduced patient's pain (P=0.000) and during six to twelve hours after operation the patients in dexamethasone group had significantly lower pain scores comparing to other group (P=0.037). The low pain scores were associated with lower requirement of supplementary analgesics (P:::0.000). Conclusion: Combination of intra-articular dexamethasone and bupivacaine significantly reduces post-operative pain and consumption of analgesics following meniscectomy than intra articular bupivacaine alone.