Postarthroscopy Analgesia with Intraarticular Bupivacaine/Morphine

Allen, Gregory C.; Amand, Marc A. St.; Lui, Anne; Johnson, Donald D.; Lindsay, M. Patrice

doi:10.1097/00000542-199309000-00010

Cited by 158 publications

(101 citation statements)

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“…Our results are in accordance with those of Heard et al who also used spinal anesthesia in one of the study groups. 1 In their study patients who received spinal anesthesia had lower VAS scores than patients who had received general anesthesia, irrespective of the intra-articular treatment and existed up to 12 hr postoperatively. Therefore, we did not ask the patients to rate their postoperative knee pain before eight hours postoperatively.…”

Section: Discussionmentioning

confidence: 89%

“…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%

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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: 89%

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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“…Outra possibilidade é o efeito preemptivo da anestesia subaracnói-dea, que impede a sensibilização de neurônios medulares e proporciona analgesia pós-operatória adequada. Ressalta-se que, nos trabalhos em que houve efeito analgé-sico com diferentes fármacos por via intra-articular, foi empregada anestesia geral 10,13,21,[23][24][25][26][27][28] . Deve ser levado em consideração que os procedimentos cirúrgicos que foram realizados poderiam ser responsáveis pela estimulação pouco intensa dos nociceptores.…”

Section: Tabela X -Efeitos Colaterais Observados Em Cada Grupounclassified

“…Talvez, se estes medicamentos fossem avaliados em outros procedimentos, os resultados teriam sido diferentes. Outros fatores descritos na literatura que poderiam interferir nos resultados seriam o volume de injeção intra-articular e o tempo da permanência do garrote após a injeção dos fárma-cos. Em muitos estudos foram utilizados grandes volumes de solução analgésica 14,24,26,29 ; entretanto, não existe consenso sobre o volume ideal para a injeção intra-articular. No presente estudo optou-se pelo volume de 10 ml, pois, de acordo com outros autores 15 , um volume maior poderia resultar no extravasamento de parte do conteúdo injetado.…”

Section: Tabela X -Efeitos Colaterais Observados Em Cada Grupounclassified

Analgesia intra-articular com morfina, bupivacaína ou fentanil após operação de joelho por videoartroscopia

Souza¹,

Issy²,

Sakata³

2002

Rev. Bras. Anestesiol.

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“…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). However, because of the high systemic absorption, the amount of local anesthetic drugs is limited when administered intraarticularly (Alagol et al, 2004).…”

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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Postarthroscopy Analgesia with Intraarticular Bupivacaine/Morphine

Cited by 158 publications

References 0 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

Analgesia intra-articular com morfina, bupivacaína ou fentanil após operação de joelho por videoartroscopia

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

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