Analgesia Following Arthroscopy - a Comparison of Intra-articular Bupivacaine and/or Midazolam and or Fentanyl
Mahmoud Nahravani, Seyed Mostafa Moosavi Tekye, Mohammad Alipour, Hadi Makhmalbaf, Monnavar Afzal Aghaee, Mahmoud Nahravani, Seyed Mostafa Moosavi Tekye, Mohammad Alipour, Hadi Makhmalbaf, Monnavar Afzal Aghaee
Abstract
Background: Arthroscopic intervention is very common for conducting orthopedic surgeries. After a knee arthroscopic surgery, different drugs are used through intra-articular administration to induce analgesia. The aim of this study was to evaluate analgesic effects of Bupivacaine (marcaine), Bupivacaine plus midazolam, and Bupivacaine plus fentanyl in reducing pain after knee arthroscopic surgery.
Methods: Frothy five patients who were candidate for knee arthroscopy were divided into three groups. Group A, B and C received Bupivacaine (50 mg), Bupivacaine (50 mg) plus midazolam (50 µg/kg), and Bupivacaine (50 mg) plus fentanyl (3 µg/kg), respectively. The analgesic solutions were diluted with normal saline up to 20 ml. The analgesic effects were evaluated by VAS during first 24 hrs after surgery. With the VAS > 4, extra analgesic (pethidine) was administrated for patient.
Results: The amount of induced analgesia and need for extra analgesic was different between groups; however, it was not statistically significant (p<0.109). The amount of administered analgesic (pethidine) in first 24 hours post-operatively was 275 mg for group A, while it was 150 mg for group B and 75 mg for group C. In group A, 46.67% of patients required further analgesic while this was 26.67% and 13.34% for groups B and C respectively (p<0.109).
Conclusion: Intra-articular administration of studied drugs in all three groups reduced post-operation pain. The amount of induced analgesia was the highest for group C, while group B drugs induced better analgesia compared to group C.
Keywords: Analgesia; Bupivacaine; Fentanyl; Intra-articular; Knee arthroscopy; Midazolam.
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Source: PubMed