Intra-articular Bupivacaine versus Bupivacaine plus Dexamethasone for Analgesia after Knee Surgery

AUTHORS

F Heshmati 1 , * , M.B Zeinaly 2 , Kh Mohammadzadeh 3 , A.R Mahoori 4

1 Assistant professor of Anesthesiology - Urmia university of Medical sciences, [email protected], Iran

2 Assistant professor of Anesthesiology, Urmia university of Medical sciences -Urmia, Iran

3 Assistant professor of Orthopedics -Urmia University of Medical sciences, Iran

4 Anesthesiologist Urmia university of Medical sciences, Iran

How to Cite: Heshmati F, Zeinaly M, Mohammadzadeh K, Mahoori A. Intra-articular Bupivacaine versus Bupivacaine plus Dexamethasone for Analgesia after Knee Surgery , Iran Red Crescent Med J. Online ahead of Print ; 8(1):39-43.

ARTICLE INFORMATION

Iranian Red Crescent Medical Journal: 8 (1); 39-43
Article Type: Research Article

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Abstract

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 group 1 (n=20) received 10ml of bupivacaine 0.5% with epinephrine 1:2000000, group 2 (n=20) received 8ml dexamethasone and group 3 (n=20) received 10ml of normal saline. The patients were evaluated until 12 hours after the operation and pain levels at rest measured by a Visual Analogue Scales(VAS)
      Results: during the firs 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 alobe.

Keywords

intra-articular,bupivacaine,dexamethasone,post-articular operative pain.

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