Background: Post-operative knee pain management have become a challenge to provide early relief and pain free postoperative care to the patient. Adequate analgesia influences the early rehabilitation of the patient and hospital stay. Many factors have been implicated to influence post arthroscopy pain such anesthetic technique, residual effects of perioperative analgesia, patient pain threshold, preoperative pain level, the use and duration of tourniquet exsanguination, surgical trauma involved, volume of drug injected, the experience of the surgeons, the sex of the patient and the postoperative activity level of the patients. The purpose of this study is to assess the efficacy of the multidrug regime for management of postoperative pain during first 24 hours. Methods: In our study 57 patients of both the sexes were evaluated for postoperative pain following various elective arthroscopic knee surgeries such as ligament reconstruction, cartilage procedures and diagnostic arthroscopic procedures. Patients were evaluated for pain using visual analogue score at 6 th hour,12 th hour and 24 hours' post-operative. A cocktail prepared of multidrug was used for the study. Results: The new cocktail regime provides adequate analgesia with no patients requiring additional analgesia for first 12 hours and only 2 patients whose VAS [visual analogue scale] was greater than 4 required additional analgesia at the end of 24 hours postoperative. Conclusion: Multi drug cocktail regime provides a good analgesic for post-operative knee arthroscopic surgery without the need of rescue analgesics. Intra articular local analgesia reduces overall use of parenteral analgesics and also helps in quicker rehabilitation.
<p class="abstract"><strong>Background:</strong> Supraspinatus tear is very common and more frequent among older individuals. Before the arthroscopy came into high demand, the open repair of supraspinatus tear was the preferred method of surgery. Recently, the mini-open technique of repair has also gained popularity because of certain factors like better repair strength, requires less expertise and facilitates early active mobilization. Still, the gold standard modality of repair is yet to be determined as both modalities are associated with good clinical outcomes and both have their pros and cons. We decided to compare functional and clinical outcomes of arthroscopic and mini-open repair.</p><p class="abstract"><strong>Methods:</strong> This was a randomised study with 32 patients in each group, aged between 18 and 60 years and all patients were cases of traumatic tear of Supraspinatus tendon. From January 2016 to March 2018, alternate patients were selected for mini-open and arthroscopic repair who fulfilled our criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Follow up was done after 12 months postoperatively and the results were evaluated using University of California Los Angeles (UCLA) shoulder score. None left the study. In arthroscopic group, out of 32 patients, 28 got excellent or good result whereas in mini open out of 32 patients 27 achieved excellent or good outcome.</p><p class="abstract"><strong>Conclusions:</strong> Arthroscopic method provides better visualization of shoulder anatomy whereas Mini-open method has better repair strength and is affordable. The necessity of an arthroscopy set up might not be required for supraspinatus repair as both the modalities show similar functional and clinical outcomes, reducing the economic burden on the patients.</p>
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