Efficacy of intra-articular dexmedetomidine versus buprenorphine for postoperative analgesia following knee arthroscopy: A comparative study

Abstract

Background: Arthroscopic knee surgery is most commonly performed minimally invasive surgical procedure in orthopaedics. Postoperative pain relief is must for early mobilisation that reduces patient's morbidity and improves postoperative recovery. Aims and Objectives: We sought to compare analgesic efficacy of intraarticular buprenorphine with dexmedetomidine following arthroscopic surgery of knee. Settings and Design: A prospective , randomized controlled double blinded study was conducted involving 60 patients undergoing arthroscopic knee surgery. Materials and Methods: Patients were allocated into group B ( n = 30) and group D ( n = 30) receiving 100 μg of intraarticular buprenorphine and 100 μg of intraarticular dexmedetomidine respectively. Parameters observed were the time to first rescue analgesia , the number of patients requiring rescue analgesia with in next 24 hours, Visual analogue scale (VAS) at rest and on mobilization at 1 st , 2 nd , 4 th , 8 th , 12 th and 24 th hour. Statistical Analysis: Quantitative data were analyzed by unpaired student's t test and categorical data by Fisher's exact test. A P < 0.05 was considered to be significant. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 19.0, SPSS Inc., Chicago, IL, USA). Results: Time to first rescue analgesia was significantly longer in patients receiving in group B. VAS scores at rest were comparable between the groups at 1 st , 2 nd , 4 th and 8 th hour but significantly low with intraarticular buprenorphine than intraarticular dexmedetomidine at 12 th and 24 th hour. VAS scores on ambulation were comparable at 1 st , 2 nd and 4 th hour but significantly higher in dexmedetomidine group as compared to buprenorphine at 8 th , 12 th and 24 th hour. Conclusion: Intraarticular buprenorphine 100 μg provides longer duration of analgesia with decreased postoperative rescue analgesic requirement as compared to 100 μg intraarticular dexmedetomidine.

The Efficacy of Buprenorphine in Preoperative and Postoperative Patients: A Literature Review

“…Differences in the VAS scores at rest were comparable between the groups, but at the 12th and 24th hours, VAS scores with intraarticular buprenorphine were considerably lower than those with intraarticular dexmedetomidine. At the first, second, and fourth hours, VAS scores on ambulation were equivalent, but at the 8th, 12th, and 24th hours, dexmedetomidine values were considerably higher than those for buprenorphine [14].…”

Pharmacokinetics of intra‐articular buprenorphine in horses with lipopolysaccharide‐induced synovitis

“…In horses, buprenorphine has been studied for the treatment of perioperative pain, showing better analgesic effects than butorphanol for field castration, at a dosage of 5 μg/kg (Rigotti et al, 2014). In human medicine, IA buprenorphine has been used for the treatment of joint pain after knee arthroscopy (Das & Samal, 2019; Sugandarajappa et al, 2016; Varrassi et al, 1999), shoulder surgery (Fellahi et al, 1995), and temporomandibular joint arthrocentesis (Präger et al, 2007).…”