Comparing the Effectiveness of Intra-Articular Injection of Bupivacaine, Dexmedetomidine Vs. 0.9% Saline on Pain Control after Arthroscopic Anterior Cruciate Ligament Reconstruction
-
Mohammad Reza Minator Sajjadi
,
Reza Zandi
,
Mohammad Ali Okhovatpour
,
Pooyan Jalalpour
,
Mohammad Reza Moshari
Abstract
Background: In different ways, drugs are administered to reduce postoperative analgesia after arthroscopic anterior cruciate ligament (ACL) reconstruction. The purpose of this study is to compare the dexmedetomidine (DEX) intra-articular injection with bupivacaine hydrochloride and sterile 0.9% saline administration following arthroscopic ACL reconstruction.
Methods: Sixty cases who underwent ACL reconstruction were randomly divided into three groups. The first group received intra-articular DEX; the second group received intra-articular bupivacaine, and the final group received intra-articular 0.9% saline. Postoperative pain was measured by the Visual Analogue Scale (VAS).
Results: The mean VAS scores at 6 and 24 hours after surgery were lower in the bupivacaine group, compared to the other groups. The pain was more severe in the control group (0.9% saline), with higher VAS scores reported at 1, 6, and 24 hours after surgery.
Conclusions: Bupivacaine has more significant effects than DEX in postoperative pain management after arthroscopic ACL reconstruction.
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2)Manuar MB, Majumdar S, Das A, Hajra BK, Dutta S, Mukherjee D, Mitra T, Kundu R. Pain relief after Arthroscopic Knee Surgery: A comparison of intra-articular ropivacaine, fentanyl, and dexmedetomidine: A prospective, double-blinded, randomized controlled study. Saudi journal of anaesthesia. 2014 Apr;8(2):233.
3)Danieli MV, Cavazzani Neto A, Herrera PA. Intra-articular bupivacaine or bupivacaine and morphine after ACL reconstruction. Acta ortopedica brasileira. 2012;20(5):258-61.
4)Panigrahi R, Roy R, Prasad A, Mahapatra AK, Priyadarshi A. High dose dexamethasone offers better postoperative analgesia than dexmedetomidine when added to intra articular ropivacaine following knee arthroscopic surgery. Anaesthesia, Pain & Intensive Care. 2019 Jan 22:273-7.
5) Sun QB, Liu SD, Meng QJ, Qu HZ, Zhang Z. Single administration of intra-articular bupivacaine in arthroscopic knee surgery: a systematic review and meta-analysis. BMC musculoskeletal disorders. 2015 Dec;16(1):21.
6) Arti H, Mehdinasab SA. The comparison effects of intra-articular injection of different opioids on postoperative pain relieve after arthroscopic anterior cruciate ligament reconstruction: A randomized clinical trial study. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2011 Sep;16(9):1176.
7)Paul S, Bhattacharjee DP, Ghosh S, Dawn S, Chatterjee N. Efficacy of intra-articular dexmedetomidine for postoperative analgesia in arthroscopic knee surgery. Ceylon Medical Journal. 2010 Dec 29;55(4).
8)Tetzlaff JE, Dilger JA, Abate J, Parker RD. Preoperative intra-articular morphine and bupivacaine for pain control after outpatient arthroscopic anterior cruciate ligament reconstruction. Regional anesthesia and pain medicine. 1999 May 1;24(3):220-4.
9)Sivapurapu V, Murugharaj SS, Venkata SS. Comparison of intra-articular analgesics in arthroscopic anterior cruciate ligament reconstruction surgeries: A randomized controlled trial. Journal of anaesthesiology, clinical pharmacology. 2017 Jul;33(3):391.
10)Haynes TK, Appadurai IR, Power I, Rosen M, Grant A. Intra‐articular morphine and bupivacaine analgesia after arthroscopic knee surgery. Anaesthesia. 1994 Jan;49(1):54-6.
11)Karlsson J, Rydgren B, Eriksson B, Järvholm U, Lundin O, Swärd L, Hedner T. Postoperative analgesic effects of intra-articular bupivacaine and morphine after arthroscopic cruciate ligament surgery. Knee Surgery, Sports Traumatology, Arthroscopy. 1995 Mar 1;3(1):55-9.
12)Agarwal RK, Payal YS, Chopra G, Agrawal A. Analgesic effect of intra-articular morphine or dexmedetomidine added with levobupivacaine in arthroscopic knee surgeries-A comparative evaluation. Journal of Clinical and Diagnostic Research: JCDR. 2017 Apr;11(4):UC13.
13)El-Hamamsy M, Dorgham M. Intra-articular adjuvant analgesics following knee arthroscopy: comparison between dexmedetomidine and fentanyl. Res J Med Med Sci. 2009;4(2):355-60.
14)Bhattacharjee DP, Biswas C, Haldar P, Ghosh S, Piplai G, Rudra JS. Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery. Journal of anaesthesiology, clinical pharmacology. 2014 Jul;30(3):387.
15)Alipour M, Tabari M. Effect of dexmedetomidine on postoperative pain in knee arthroscopic surgery; a randomized controlled clinical trial. Archives of bone and joint surgery. 2014 Mar;2(1):52.
16)Peng K, Chen WR, Meng XW, Zhang J, Ji FH. Intra-articular dexmedetomidine in knee arthroscopy: A systematic review and meta-analysis. Scientific reports. 2018 Mar 6;8(1):4089.
17) Al-Metwalli RR, Mowafi HA, Ismail SA, Siddiqui AK, Al-Ghamdi AM, Shafi MA, El-Saleh AR. Effect of intra-articular dexmedetomidine on postoperative analgesia after arthroscopic knee surgery. British journal of anaesthesia. 2008 Jun 20;101(3):395-9.
2)Manuar MB, Majumdar S, Das A, Hajra BK, Dutta S, Mukherjee D, Mitra T, Kundu R. Pain relief after Arthroscopic Knee Surgery: A comparison of intra-articular ropivacaine, fentanyl, and dexmedetomidine: A prospective, double-blinded, randomized controlled study. Saudi journal of anaesthesia. 2014 Apr;8(2):233.
3)Danieli MV, Cavazzani Neto A, Herrera PA. Intra-articular bupivacaine or bupivacaine and morphine after ACL reconstruction. Acta ortopedica brasileira. 2012;20(5):258-61.
4)Panigrahi R, Roy R, Prasad A, Mahapatra AK, Priyadarshi A. High dose dexamethasone offers better postoperative analgesia than dexmedetomidine when added to intra articular ropivacaine following knee arthroscopic surgery. Anaesthesia, Pain & Intensive Care. 2019 Jan 22:273-7.
5) Sun QB, Liu SD, Meng QJ, Qu HZ, Zhang Z. Single administration of intra-articular bupivacaine in arthroscopic knee surgery: a systematic review and meta-analysis. BMC musculoskeletal disorders. 2015 Dec;16(1):21.
6) Arti H, Mehdinasab SA. The comparison effects of intra-articular injection of different opioids on postoperative pain relieve after arthroscopic anterior cruciate ligament reconstruction: A randomized clinical trial study. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2011 Sep;16(9):1176.
7)Paul S, Bhattacharjee DP, Ghosh S, Dawn S, Chatterjee N. Efficacy of intra-articular dexmedetomidine for postoperative analgesia in arthroscopic knee surgery. Ceylon Medical Journal. 2010 Dec 29;55(4).
8)Tetzlaff JE, Dilger JA, Abate J, Parker RD. Preoperative intra-articular morphine and bupivacaine for pain control after outpatient arthroscopic anterior cruciate ligament reconstruction. Regional anesthesia and pain medicine. 1999 May 1;24(3):220-4.
9)Sivapurapu V, Murugharaj SS, Venkata SS. Comparison of intra-articular analgesics in arthroscopic anterior cruciate ligament reconstruction surgeries: A randomized controlled trial. Journal of anaesthesiology, clinical pharmacology. 2017 Jul;33(3):391.
10)Haynes TK, Appadurai IR, Power I, Rosen M, Grant A. Intra‐articular morphine and bupivacaine analgesia after arthroscopic knee surgery. Anaesthesia. 1994 Jan;49(1):54-6.
11)Karlsson J, Rydgren B, Eriksson B, Järvholm U, Lundin O, Swärd L, Hedner T. Postoperative analgesic effects of intra-articular bupivacaine and morphine after arthroscopic cruciate ligament surgery. Knee Surgery, Sports Traumatology, Arthroscopy. 1995 Mar 1;3(1):55-9.
12)Agarwal RK, Payal YS, Chopra G, Agrawal A. Analgesic effect of intra-articular morphine or dexmedetomidine added with levobupivacaine in arthroscopic knee surgeries-A comparative evaluation. Journal of Clinical and Diagnostic Research: JCDR. 2017 Apr;11(4):UC13.
13)El-Hamamsy M, Dorgham M. Intra-articular adjuvant analgesics following knee arthroscopy: comparison between dexmedetomidine and fentanyl. Res J Med Med Sci. 2009;4(2):355-60.
14)Bhattacharjee DP, Biswas C, Haldar P, Ghosh S, Piplai G, Rudra JS. Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery. Journal of anaesthesiology, clinical pharmacology. 2014 Jul;30(3):387.
15)Alipour M, Tabari M. Effect of dexmedetomidine on postoperative pain in knee arthroscopic surgery; a randomized controlled clinical trial. Archives of bone and joint surgery. 2014 Mar;2(1):52.
16)Peng K, Chen WR, Meng XW, Zhang J, Ji FH. Intra-articular dexmedetomidine in knee arthroscopy: A systematic review and meta-analysis. Scientific reports. 2018 Mar 6;8(1):4089.
17) Al-Metwalli RR, Mowafi HA, Ismail SA, Siddiqui AK, Al-Ghamdi AM, Shafi MA, El-Saleh AR. Effect of intra-articular dexmedetomidine on postoperative analgesia after arthroscopic knee surgery. British journal of anaesthesia. 2008 Jun 20;101(3):395-9.
| Files | ||
| Issue | Vol 4, No 2 (2018) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v4i2.2957 | |
| Keywords | ||
| Intra-Articular Injections; Postoperative Pain; Arthroscopy; Anterior Cruciate Ligament Reconstruction; Bupivacaine; Dexmedetomidine | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Minator Sajjadi MR, Zandi R, Okhovatpour MA, Jalalpour P, Moshari MR. Comparing the Effectiveness of Intra-Articular Injection of Bupivacaine, Dexmedetomidine Vs. 0.9% Saline on Pain Control after Arthroscopic Anterior Cruciate Ligament Reconstruction. J Orthop Spine Trauma. 2020;4(2):23-25.
