Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery

Bhattacharjee, Dhurjoti Prosad; Biswas, Chaitali; Haldar, Purba; Ghosh, Subrata; Piplai, Gautam; Rudra, Jati Sankar

doi:10.4103/0970-9185.137273

Cited by 24 publications

(19 citation statements)

References 10 publications

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“…Corticosteroids may be administered through the intra-articular route to decrease the intensity and duration of pain [19]. Scholten et al [20] confirmed that fluoroscopically guided corticosteroid injections, based on arthrographic contrast patterns, into the superior portion of SIJ were effective in de- for LBP, this study did not find any statistically significant difference in the mean BMI between the discharged and transferred groups.…”

Section: Discussionmentioning

confidence: 51%

Treatment outcomes of peri-articular steroid injection for patients with work-related sacroiliac joint pain and lumbar para-spinal muscle strain

Medani¹,

Bvute²,

Narayan³

et al. 2021

Int J Occup Med Environ Health

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Objectives: Evaluating treatment outcomes of local corticosteroid injections for work-related lower back pain (LBP) as the current evidence for the American College of Occupational and Environmental Medicine guidelines is considered insufficient to recommend this practice. Material and Methods: The authors conducted a retrospective study involving the patients who were treated with peri-articular and lower lumbar corticosteroid injections for work-related LBP at their occupational medicine clinic. Results: Sixty-four patients met the inclusion criteria. The average pain level was reduced from M±SD 5.1±2.0 to M±SD 3.1±2.3 after the corticosteroid injection (p < 0.0001). Thirty-five patients (55%) were discharged to regular duty; 23 (36%) were transferred to orthopedics due to persistent pain; and 6 (9%) were lost to follow-up. Conclusions: Corticosteroid injections for work-related LBP are effective in reducing pain and enhancing discharge to regular duty. Nonetheless, larger prospective trials are needed to validate these findings.

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Section: Discussionmentioning

confidence: 51%

Treatment outcomes of peri-articular steroid injection for patients with work-related sacroiliac joint pain and lumbar para-spinal muscle strain

Medani¹,

Bvute²,

Narayan³

et al. 2021

Int J Occup Med Environ Health

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“…Dexamethasone is a potent and highly selective glucocorticoid with minimal mineralocorticoid effects. It inhibits nociceptive impulse transmission along myelinated C-fibers, and when combined with local anesthetics, it increases the duration of regional blocks (28,29). Intraarticular ropivacaine has only been shown to be effective when it is administered with other drugs, not when used alone (15) ; therefore, dexamethasone was used in this study to increase analgesic efficacy.…”

Section: Discussionmentioning

confidence: 99%

Postoperative nausea and vomiting following lower limb surgery :a comparison between single-injection intraarticular anesthesia and continuous epidural anesthesia

et al. 2019

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Study Objective : the incidence of postoperative nausea and vomiting (PONV) following single-injection intraarticular anesthesia was compared to that following continuous epidural anesthesia. Design : Prospective, double-blind, randomized study. Setting : University-affiliated teaching hospital. Patients : Forty-eight patients finally participated in this study, and each group contained twenty-four patients. Interventions : Patients scheduled to undergo lower limb surgery under general anesthesia were randomly allocated into two groups, to receive either single-injection intraarticular or continuous epidural anesthesia for postoperative analgesia. Measurements : The incidence and severity of PONV, complete response rates (i.e., no vomiting or rescue antiemetic use), and pain scores were recorded 2, 24, and 48 h postoperatively. Main results : No significant differences between groups were observed in the incidence and severity of PONV, rescue antiemetic use, or complete response rate at any of the time points, but only the use of rescue analgesics was significantly less in continuous epidural anesthesia group during the 2-24h postoperative period (P=0.04). Conclusion : While the use of single-injection intraarticular anesthesia following lower limb surgery did not prevent PONV more than continuous epidural anesthesia in this study, the intraarticular technique still provides greater simplicity, safety, and cost-effectiveness.

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“…Levobupivacaine is S-enantiomer of bupivacaine and has a longer effect compared to bupivacaine. There is no study regarding levobupivacaine toxicity in IA administration and data on its IA use is limited ( 12 - 16 ). In a study by Kazak Bengisun et al ( 16 ), IA levobupivacaine and bupivacaine were compared with saline (control); both local anesthetics decreased pain scores at rest and after movement and consumption of postoperative tramadol compared saline.…”

Section: Discussionmentioning

confidence: 99%

The Analgesic Effects of Morphine and Tramadol Added to Intra-articular Levobupivacaine-Tenoxicam Combination for Arthroscopic Knee Surgery on Postoperative Pain; a Randomized Clinical Trial

Oral¹,

Hanci²,

Sivrikaya

et al. 2015

Anesth Pain Med

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Background:Arthroscopic knee surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain.Objectives:We aimed to compare the effects of intra-articular levobupivacaine-tenoxicam-tramadol and levobupivacaine-tenoxicam-morphine combinations on postoperative pain in patients undergoing elective arthroscopic knee surgery.Materials and Methods:A total of 90 ASA I-II patients undergoing elective arthroscopic meniscectomy under general anesthesia were enrolled. The participants were randomly allocated to three groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group S, 20 mL of saline; Group T, 35 mg of levobupivacaine, 20 mg of tenoxicam, and 100 mg of tramadol in 20 mL saline; and Group M, 35 mg of levobupivacaine, 20 mg of tenoxicam, and 4 mg of morphine in 20 mL saline. Visual analogue scale values at rest (VASr) and at active flexion of knee (VASa) at postoperation hours 1, 2, 4, 8, 12, and 24, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated.Results:VASr and VASa were significantly higher in group S in comparison to other groups (P < 0.05). Duration of analgesia was significantly longer in Group T and Group M than in Group S (P < 0.05). The difference between group T and group M was also significant (P < 0.05). Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group M compared with other groups (P < 0.05).Conclusions:Intra-articular levobupivacaine-tenoxicam-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular levobupivacaine-tenoxicam-tramadol combination and saline after knee arthroscopic surgery.

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Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery

Cited by 24 publications

References 10 publications

Treatment outcomes of peri-articular steroid injection for patients with work-related sacroiliac joint pain and lumbar para-spinal muscle strain

Treatment outcomes of peri-articular steroid injection for patients with work-related sacroiliac joint pain and lumbar para-spinal muscle strain

Postoperative nausea and vomiting following lower limb surgery :a comparison between single-injection intraarticular anesthesia and continuous epidural anesthesia

The Analgesic Effects of Morphine and Tramadol Added to Intra-articular Levobupivacaine-Tenoxicam Combination for Arthroscopic Knee Surgery on Postoperative Pain; a Randomized Clinical Trial

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