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.