Intra-articular sufentanil in multimodal analgesic management after outpatient arthroscopic anterior cruciate ligament reconstruction: a prospective, randomized, double-blinded study.
OBJECTIVE
This prospective, randomized, blinded study was designed to evaluate the effectiveness of intra-articular sufentanil, ropivacaine, and clonidine compared with that of ropivacaine and clonidine without sufentanil on postoperative pain after arthroscopic reconstruction of the anterior cruciate ligament of the knee.


METHODS
One hundred twenty patients were enrolled and randomly divided into 2 groups. At the end of the operation, the surgeon injected 20 mL of a solution containing 5 microg sufentanil, 100 mg ropivacaine, and 1 microg/kg clonidine in the knees of patients in group A whereas the surgeon injected the same solution without sufentanil in group B. During the postoperative period and for the first 24 hours, we recorded pain intensity using a visual analog scale.


RESULTS
All patients were discharged after a few hours with well-controlled pain. Pain scores were low in both groups both before and after discharge. We did not show any difference in pain scores at any time point. During the first postoperative hour, patients in group B required more rescue analgesic drugs (P < .05).


CONCLUSIONS
In our patients the addition of sufentanil in the intra-articular solution did not provide better control of pain.


METHODS
Level I, therapeutic randomized controlled trial.
Armellin
Gabriele
G
Institute of Anesthesia and Intensive Care, University of Padua, Padua, Italy. gabriarmellin@libero.it
Nardacchione
Roberto
R
Ori
Carlo
C
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000577:Amides / Q000008:administration & dosage; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D003000:Clonidine / Q000008:administration & dosage; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D010359:Patient Readmission / Q000706:statistics & numerical data; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D000077212:Ropivacaine; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D000577:Amides; D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D017409:Sufentanil; D003000:Clonidine