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Evaluation and comparison of intra-articular Ropivacaine, Clonidine and Fentanyl on postoperative analgesia following arthroscopic knee surgery

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Original Article

Author Details : Kavita Udaykumar Adate, Kalyani Nilesh Patil, Prashant Vilas Bhandari

Volume : 3, Issue : 4, Year : 2016

Article Page : 540-545

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Abstract

Background and Aims: Arthroscopic knee surgery is the commonest orthopaedic day care procedure. It is associated with variable amount of pain. Various drugs and routes have been tried till date for the postoperative analgesia. The aim of our study is to evaluate and compare the efficacy as well as safety of intra-articular (IA) Ropivacaine, Clonidine and Fentanyl on postoperative analgesia following arthroscopic surgery on the knee.
Methods: In this prospective, double blind study, 75 patients were enrolled. Therapeutic knee arthroscopy was performed under spinal anaesthesia. At the end of procedure patients were randomly assigned into one of the three groups to receive intra-articular study drug. Group C (n=25) received injection clonidine 1?g/kg in 20 ml normal saline, Group F (n=25) received injection fentanyl 1?g/kg in 20 ml normal saline and Group R (n=25) received 0.2% ropivacaine 20ml. Analgesic efficacy of IA study drug was measured by the pain intensity quantified using VAS score at the 2nd, 4th, 6th, 8th, 12th and 24th hour after spinal anaesthesia. Intramuscular injection diclofenac sodium 75 mg was given as rescue analgesic if the VAS?4. Time of first rescue analgesia and total rescue analgesics consumption in first 24 hrs in postoperative period were calculated.
Result: Postoperative VAS scores were significantly lower in group R. Time to first analgesic requirement was significantly greater in Group R (20±2.82) than in Group C (6.96±1.94) and Group F(10.32±2.21)hours, p?0.001. Also, the total dose of analgesic used in Group R (0.08±0.27) was significantly lower compared to study population in Group C (1.96±0.61) and Group F (1.44±0.5), p?0.001.
Conclusion: In comparison with intraarticular fentanyl and clonidine, 0.2% ropivacaine improves the quality and prolongs duration of postoperative analgesia in arthroscopic knee surgery under spinal anaesthesia, without any complications.

Keywords: Arthroscopy, Clonidine, Fentanyl, Intraarticular, Postoperative, Ropivacaine

How to cite : Adate K U, Patil K N, Bhandari P V, Evaluation and comparison of intra-articular Ropivacaine, Clonidine and Fentanyl on postoperative analgesia following arthroscopic knee surgery. Indian J Clin Anaesth 2016;3(4):540-545

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