Analgesic Effect of Intra-articular Morphine or Dexmedetomidine Added with Levobupivacaine in Arthroscopic Knee Surgeries - A Comparative EvaluationCorrespondence Address :
Dr. Yashwant Singh Payal,
Department of Anaesthesia, Himalayan Institute of Medical Sciences, SRH University, Dehradun-248140, Uttarakhand, India.
Introduction: Knee arthroscopy is associated with variable amount of postoperative pain. In an attempt to improve postoperative analgesia, intra-articular injection of local anaesthetic in combination with other agent have been studied. However, the best combination is not known.
Aim: To compare the analgesic efficacy of intra-articular injection of morphine and dexmedetomidine when added with levobupivacaine in arthroscopic knee surgeries.
Materials and Methods: Seventy eight patients, scheduled to undergo elective arthroscopic procedure under spinal anaesthesia were recruited for the study. All the patients received 18 ml of 0.25% levobupivacaine however in addition to this Group M patients received 8 mg (2 ml) morphine, Group D patients received 100µg (2 ml) of dexmedetomidine while Group C patients received 2 ml of isotonic saline intraarticularly. Postoperatively the intensity of pain was assessed using Numerical Rating Scale (NRS). Rescue analgesia was given at NRS = 4. The duration of analgesia and total diclofenac consumption was noted.
Results: The mean duration of analgesia was longest in Group M (576.20±67.09 minutes) followed by Group D (460.93±38.95 minutes) and Group C (370.27±58.80 minutes) statistically this difference was found to be highly significant (p-value < 0.001). Total consumption of diclofenac in 24 hours was found lowest in group M (86.25±27.48 mg) followed by group D (110.87±44.48 mg) and group C (141.35±44.13 mg) this difference was found to be highly significant (p-value < 0.001).
Conclusion: Morphine when added with levobupivacaine in patients undergoing arthroscopic knee surgery improves the quality and prolongs the duration of postoperative analgesia.
Anaesthetic technique, Diclofenac sodium, Postoperative analgesia, Synergistic effect
Date of Submission: Oct 26, 2016
Date of Peer Review: Dec 03, 2016
Date of Acceptance: Dec 11, 2016
Date of Publishing: Apr 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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