BACKGROUND AND AIMSPain after orthopaedic surgery depends on the site and extent of surgery and the preoperative use of analgesics by the patient. Arthroscopic procedures are routinely performed on outpatient basis and have spared patients large incisions and decreased morbidity compared with open incisions, but has not eliminated pain. At present several techniques are available to treat pain following arthroscopic surgeries; these include the use of opioids, local anaesthetics, NSAIDs, corticosteroids, clonidine and cryotherapy. Here, we compared the analgesic effect of intra-articular administration of morphine, buprenorphine and placebo following arthroscopic surgery of knee.
BACKGROUND AND OBJECTIVESMagnesium has antinociceptive effects in animal and human models of pain. It is found that the addition of magnesium to postoperative epidural infusion of fentanyl may decrease the need for fentanyl. We undertook a study to compare the duration of postoperative analgesia after epidural Fentanyl and epidural Fentanyl plus magnesium administered postoperatively, along with side effects.
Introduction: Epidural analgesia has emerged as one of the preferred and convenient modes of intraoperative and postoperative management owing to advantage of not interfering with metabolic functions, better tolerability and decrease in reflex activity, similar analgesic properties, less motor blockade and decreased propensity of cardiotoxicity. Neuraxial opioids like fentanyl used in epidural analgesia offer advantage of augmenting local anaesthetic effect and reducing the anaesthetic and analgesic requirement. Aim: To compare the adequacy of analgesia, requirement of rescue analgesics between 0.2% ropivacaine and 0.2% ropivacaine with 2 mcg/cc fentanyl. Materials and Methods: The randomised clinical study was carried out from September 2016 to May 2018 in 70 patients (35 in each group) of American Society of Anaesthesiologists (ASA) 1 and 2 scheduled for elective lower abdominal oncological surgeries. The anaesthetic intervention in group R was 0.2 % ropivacaine and group RF was 0.2% ropivacaine with 2 mcg/cc fentanyl. All data was statistically analyzed and compared using Student t-test, Chi-square/Fisher-Exact test. The p-value <0.05 was considered to be significant. Results: Both the groups were compatible with regard to demographic data and haemodynamic variables. The mean Visual Analogue Scale (VAS) were higher in group R compared to group RF at 0, 2, 4, 12, 18 and 24 hours but the observed difference in both the groups was not statistically significant except at 1 and 6 hours. Number of rescue analgesics as epidural boluses (p-value=0.007) and paracetamol (p-value=0.022) requirement were more in group R compared to group RF respectively. Conclusion: On account of adequate postoperative analgesia, haemodynamic stability, ropivacaine with fentanyl is a better option than ropivacaine alone for epidural infusion.
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