Pain relief after Arthroscopic Knee Surgery: A comparison of intra-articular ropivacaine, fentanyl, and dexmedetomidine: A prospective, double-blinded, randomized controlled study.
BACKGROUND
Postoperative pain is very common distressing symptom after any surgical procedure. Different drugs in different routes have been used for controlling post-arthroscopic pain. No one proved to be ideal. We have compared the analgesic effect of ropivacaine, fentanyl, and dexmedetomidine when administered through the intra-articular route in arthroscopic knee surgery.


METHODS
From March 2008 to July 2010, 99 patients undergoing arthroscopic knee surgery were randomly assigned into three groups (A,B,C) in a prospective double-blinded fashion. Group A received 10 ml of 0.75% ropivacaine, where Group B received 50 μg fentanyl, and Group C received 100 μg of dexmedetomidine through the intra-articular route at the end of procedure. Pain assessed using visual analog scale and diclofenac sodium given as rescue analgesia when VAS >4. Time of first analgesia request and total rescue analgesic used in 24 hours were calculated.


RESULTS
Demographic profiles are quite comparable among the groups. Time for requirement of first postoperative rescue analgesia in Group A was 380.61 ± 22.973 min, in Group B was 326.82 ± 17.131 min and in Group C was 244.09 ± 20.096 minutes. Total rescue analgesia requirement was less in Group A (1.394 ± 0.496) compared to Group B (1.758 ± 0.435) and Group C (2.546 ± 0.546). Group A had higher mean VAS score at 6(th) and 24(th) postoperative hours. No side effects found among the groups.


CONCLUSIONS
Therefore, it suggests that intra-articular ropivacaine gives better postoperative pain relief, with increased time of first analgesic request and decreased need of total postoperative analgesia compared to fentanyl and dexmedetomidine.
Department of Anaesthesiology, NRS Medical College, Kolkata, West Bengal, India.
Mohammed Babrak
MB
Manuar
Department of Anaesthesiology, NRS Medical College, Kolkata, West Bengal, India.
Saikat
S
Majumdar
Department of College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
Anjan
A
Das
Department of Anaesthesiology, NRS Medical College, Kolkata, West Bengal, India.
Bimal Kumar
BK
Hajra
Department of Orthopedics, R.G. Kar Medical College, Kolkata, West Bengal, India.
Soumyadip
S
Dutta
Department of Anaesthesiology, NRS Medical College, Kolkata, West Bengal, India.
Dipankar
D
Mukherjee
Department of R.M.O cum CT, B.I.N, Kolkata, West Bengal, India.
Tapobrata
T
Mitra
Department of R.M.O cum CT, B.I.N, Kolkata, West Bengal, India.
Ratul
R
Kundu
Dexmedetomidine; fentanyl; intra-articular; rescue analgesia; ropivacaine