Comparison of Intra-Articular Injection of Morphine Versus Dexmedetomidine as an Adjuvant to Bupivacaine in Arthroscopic Knee Surgeries for Post-Operative Analgesia: A Randomised Double Blinded Study

Abstract

Objective Despite its proven pain-relieving properties, the analgesic effect of intra-articular bupivacaine when administered without adjuvants remains short-lived. The aim of this study was to compare intra-articular injection of Morphine versus Dexmedetomidine as an adjuvant to bupivacaine in arthroscopic knee surgeries for post-operative analgesia Methods A randomized double blinded study was conducted in 60 adults of American Society of Anaesthesiologists (ASA) I & II undergoing elective arthroscopic knee surgery. Patients were randomized to receive morphine 5mg (group M) or dexmedetomidine 1microgram/kg (group D) in combination with bupivacaine 0.25% 19cc. Vitals, Ramsay sedation score and VAS were monitored. Diclofenac Sodium (75mg) was administered intravenously as rescue analgesic at VAS >3. Time to rst request of analgesic and dosage of total analgesic consumption in 24 hours were recorded. Adverse effects, if any were noted. Cases in group M had Results adequate analgesia for 16.20 ± 3.75 hours which was signicantly higher (p value <0.001) than those in group D, that lasted for 9.47 ± 1.36 hours. Total number of analgesic injections required were higher in Group D than in group M (p value <0.001). In group M, none had any side effects while 2 out of 30 in group D had hypotension and urinary retention respectively. Conclusion Combination of intra-articular morphine with bupivacaine provides better analgesia than with dexmedetomidine with prolongation of time required to use rescue analgesic in post-arthroscopic knee surgery.