Intraarticular bupivacaine (Marcaine) after arthroscopic meniscectomy: A randomized double-blind controlled study

Chirwa, S.S.; MacLeod, Bernard A.; Day, Brian J.

doi:10.1016/0749-8063(89)90087-x

Cited by 132 publications

(101 citation statements)

References 4 publications

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“…Diclofenac premedication but not intra-articular ropivacaine alleviates pain following day-case knee arthroscopy NTRA-ARTICULAR bupivacaine has been shown in some studies to provide postoperative analgesia after knee arthroscopy, [1][2][3][4][5][6][7][8] but others have failed to demonstrate such an effect. [8][9][10][11] These investigations have been performed in healthy patients under general, spinal (subarachnoidal), epidural or local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Diclofenac premedication but not intra-articular ropivacaine alleviates pain following day-case knee arthroscopy

Rautoma

Santanen

Avela

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To compare the postoperative analgesic effects of 50 mg diclofenac po before surgery and intra-articular ropivacaine injected after diagnostic day-case knee arthroscopy performed under spinal anesthesia.Methods: In a randomized, double-blind investigation, 200 ASA physical status 1-2 outpatients, age 18-60 yr, received either 50 mg diclofenac po or placebo one hour before operation (100 patients per group), and intraarticular injections of either 20 ml of ropivacaine 0.5% or 20 ml of saline 0.9% (50 patients in each premedication groups). Patients received 50 mg diclofenac po prn and, if needed, 0.1 mg·kg -1 oxycodone im for postoperative pain relief. Patients were discharged home with a supply of 50 mg diclofenac tablets and were given a sheet of paper with knee pain VAS scales and a questionnaire of analgesics taken. Patients rated their VAS scores eight hours after surgery and in the morning and at the end of the first and the second postoperative days, respectively.Results: The only statistically significant difference was found when the diclofenac groups were combined and compared with the combined placebo premedication groups. The VAS scores of knee pain at eight hours after the operation were 19 ± 22 in the two diclofenac premedication groups and 32 ± 28 in the two placebo groups (P=0.001).Conclusions: Diclofenac premedication po reduced the VAS scores at eight hours postoperatively while intraarticular ropivacaine did not.Objectif : Comparer les effets analgésiques postopératoires de 50 mg de diclofénac po, administrés avant l'opération, à la ropivacaïne intra-articulaire, donnée après l'arthroscopie diagnostique sous rachianesthésie.Méthode : Lors d'une étude randomisée et en double aveugle, 200 patients d'état physique ASA I-II, âgés de 18-60 ans, ont reçu 50 mg de diclofénac po ou un placebo une heure avant l'opération (100 patients par groupe), et une injection intra-articulaire de 20 ml de ropivacaïne 0,5 % ou 20 ml de solution salée 0,9 % (50 patients dans chaque groupe de prémédication). Les patients ont reçu 50 mg de diclofénac po prn et, si nécessaire, 0,1 mg·kg -1 d'oxycodone im pour soulager la douleur postopératoire. À leur départ, ils ont reçu des comprimés de 50 mg de diclofénac, un questionnaire concernant la prise d'analgésiques et une feuille de papier où inscrire le niveau de douleur au genou selon l'EVA. Les patients ont estimé leurs scores à l'EVA huit heures après l'opéra-tion et au début et à la fin du premier et du deuxième jours postopératoires, respectivement.Résultats : La seule différence statistique significative a été trouvée en combinant les groupes de diclofénac et en les comparant aux groupes combinés de prémédication placebo. Les scores postopératoires de l'EVA ont été de 19 ± 22 dans les deux groupes qui ont reçu une prémédication de diclofénac et de 32 ± 28 dans les groupes qui ont reçu le placebo (P=0,001). Conclusion :La prémédication au diclofénac po a réduit les scores postopératoires de l'EVA à huit heures, mais non pas la ropivacaïne intra-articulaire.

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Section: Discussionmentioning

confidence: 99%

Diclofenac premedication but not intra-articular ropivacaine alleviates pain following day-case knee arthroscopy

Rautoma

Santanen

Avela

et al. 2000

Can J Anesth/J Can Anesth

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“…In human medicine Intraarticular local anesthetics and/or opioids are often used for the management and prevention of pain after arthroscopic surgeries (Chirwa et al, 1989;Dahl et al, 1990;Stein et al, 1991;Khoury et al, 1992;Reuben and Connelly, 1996;Kanbak et al, 1997). The addition of opioids to local anesthetics increases the analgesic effect during the postoperative period, which is the rationale of the multimodal analgesia (Allen et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Effects of Intraarticular Tramadol Administration on Biochemical and Cytological Properties of Equine Synovial Fluid: Comparison with Lidocaine

Jahromi¹

2011

American Journal of Pharmacology and Toxicology

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Problem statement: Diagnostic and therapeutic arthroscopic surgeries are procedures performed quite frequently in equine practice; and are considered to cause some degree of postoperative pain. The aim of the present study was to evaluate the equine synovial fluid biochemical and cytological changes following intra-articular administration of tramadol as a potential analgesic. Approach: Six adult healthy donkeys were selected after clinical examination. Synovial fluid samples were taken from both middle carpal joints after routine preparation. Tramadol 2 mg kg −1 and 100 mg lidocaine 2% were administered to the right and left joints respectively. Synovial fluid collection from the joints was performed at 12, 24, 48-192 h after medication. Cytological examination, total protein, glucose, specific gravity, Alkaline Phosphates (ALP), Aspartate Aminotransferase (AST), Lactate Dehydrogenase (LDH), viscosity and quality of mucin clot were measured. Comparison of treatments was performed by nonparametric sign test and Wilcoxon rank sum test. Significance level was set to p ≤ 0.05. Results: Neither detectable lameness nor special side effect was observed throughout the study. Mucin clot quality test and viscosity, the amount of total nucleated cell count, glucose, ALP and LDH revealed no significant differences between various sampling times between the tramadol and lidocaine groups (P>0.05). Neutrophil count, total protein, specific gravity and AST activity were significantly different. Conclusion/Recommendations: Despite the slightly different results compared to the lidocaine, it seems that the injection of tramadol into the middle carpal joint has no adverse effects on the synovial fluid composition in this joint and it can be considered a good analgesic after arthroscopic surgery with the lowest side effects in horses.

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“…Intra-articular dexmedetomidine with bupivacaine have shown to reduce postoperative pain after arthroscopic knee surgery. [3] So, the purpose of this clinical study was to compare the analgesic efficacy of intra-articular levobupivacaine (0.75%) with dexmedetomidine 1 mcg/kg and ropivacaine (0.5%) with dexmedetomidine after arthroscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

Dhar¹,

Mohanty²,

Routray³

2017

AIMDR

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Background: Local anaesthetics in intra-articular route are commonly used for the management of pain after arthroscopic knee surgery. Dexmedetomidine prolongs the duration of commonly used local anesthetics. In this study, analgesic effect of intra-articular administration of levobupivacaine and dexmedetomidine was compared with ropivacaine and dexmedetomidine in arthroscopic knee surgery. Methods: 80 patients, aged between 20 to 60 years of ASA I and II posted for knee arthroscopy were divided into two equal groups (n = 40) in a randomized double blind study. Patients in Group LD received 10 ml of 0.5% levobupivacaine and 1 mcg/kg dexmedetomidine and Group RD received 10 ml of 0.75% ropivacaine and 1 mcg/kg of dexmedetomidine through intra-articular route at the end of the surgery. In the post-operative period, pain intensity was assessed by visual analogue scale(VAS) VAS score was recorded at 1 st , 5 th , 8 th , 12 th and 18 th post-operative hours. Duration of analgesia, total rescue analgesic requirement in first 18 hours and any side effects were recorded. Results: Group LD showed significantly longer duration of postoperative analgesia and lesser rescue analgesic requirement compared to group RD. Group RD had higher mean VAS score at 5 th and 12 th post-operative hours compare to group LD. Conclusion: Intra-articular levobupivacaine and dexmedetomidine combine provides better postoperative pain relief by increasing duration of the analgesia, and decreasing the need of rescue analgesic compared to intra-articular ropivacaine and dexmedetomidine.

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Intraarticular bupivacaine (Marcaine) after arthroscopic meniscectomy: A randomized double-blind controlled study

Cited by 132 publications

References 4 publications

Diclofenac premedication but not intra-articular ropivacaine alleviates pain following day-case knee arthroscopy

Diclofenac premedication but not intra-articular ropivacaine alleviates pain following day-case knee arthroscopy

Effects of Intraarticular Tramadol Administration on Biochemical and Cytological Properties of Equine Synovial Fluid: Comparison with Lidocaine

Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

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