title: Comparison of the effects of intra-articular sole ropivacaine and combined ketorolac and ropivacaine for pain control after knee arthroscopy surgery.
abstract: BACKGROUND
  Effective pain relief is important after arthroscopic knee surgery to permit initiation of daily activities of life. This study is performed in order to investigate the effect of multi-model therapy for pain control after surgery. This clinical, randomized and double-blind trial is conducted on patients who get knee arthroscopy surgery.
  
  
  METHODS
  Of these patients, 40 were divided into two groups by Block Randomization method: 1 - sole ropivacaine group (150 mg); 2 - combined ketorolac (30 mg); and ropivacain (150 mg) group. These drugs were injected intra-articularly at the end of knee arthroscopic surgery. The first consequence including measurement of pain severity after entrance to recovery room and 2, 4, 8, 12, 18 and 24 hours after surgery were evaluated according to the visual analogue pain score. The second consequence, including nausea, vomiting and sedation, was assessed by expert nurses in the recovery room and surgery part according to nausea and vomiting scale and Ramsay sedation scale, respectively.
  
  
  RESULTS
  All groups had excellent analgesia at 0 and 4 hours, postoperatively. Group-combined ketorolac and ropivacaine had significantly lower visual analogue pain score as well as higher sedative scale at 8, 12, 18 and 24 hours after surgery at rest and during movement compared with the other group (p < 0.05). Moreover, there was no statistical difference between groups in regard of nausea and vomiting.
  
  
  CONCLUSIONS
  Addition of ketolorac to ropivacaine intra-articularly in arthroscopic knee surgery enhances analgesic efficacy of local anaesthetics and cause more sedation after surgery.
authors.affiliation: Firouzgar Hospital, Anesthesiology Group, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Faranak
authors.initials: F
authors.lastname: Rokhtabnak
authors.affiliation: Rasul Akram Hospital, Anesthesiology Group, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmood Reza
authors.initials: MR
authors.lastname: Ale Bouyeh
authors.affiliation: Fatemeh Hospital, Anesthesiology Group, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Seyed Siamdust
authors.affiliation: Rasul Akram Hospital, Anesthesiology Group, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Masoomshahi
authors.affiliation: Department of Physiology, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Aghajani
keywords: Ropivacaine; arthroscopic knee surgery; intra-articular; ketorolac; nausea and vomiting; pain; sedation