Comparison of the effects of intra-articular sole ropivacaine and combined ketorolac and ropivacaine for pain control after knee arthroscopy surgery

Abstract

Introduction: Effective pain relief is important after arthroscopic knee surgery to permit initiation of daily activities of life. This study is performed in order to investigate the effect of multi-model therapy for pain control after surgery. This clinical, randomized and double-blind trial is conducted on patients who get knee arthroscopy surgery.

Methods: Of these patients, 40 were divided into two groups by Block Randomization method: 1 - sole ropivacaine group (150 mg); 2 - combined ketorolac (30 mg); and ropivacain (150 mg) group. These drugs were injected intra-articularly at the end of knee arthroscopic surgery. The first consequence including measurement of pain severity after entrance to recovery room and 2, 4, 8, 12, 18 and 24 hours after surgery were evaluated according to the visual analogue pain score. The second consequence, including nausea, vomiting and sedation, was assessed by expert nurses in the recovery room and surgery part according to nausea and vomiting scale and Ramsay sedation scale, respectively.

Results: All groups had excellent analgesia at 0 and 4 hours, postoperatively. Group-combined ketorolac and ropivacaine had significantly lower visual analogue pain score as well as higher sedative scale at 8, 12, 18 and 24 hours after surgery at rest and during movement compared with the other group (p < 0.05). Moreover, there was no statistical difference between groups in regard of nausea and vomiting.

Conclusion: Addition of ketolorac to ropivacaine intra-articularly in arthroscopic knee surgery enhances analgesic efficacy of local anaesthetics and cause more sedation after surgery.

Keywords: Ropivacaine; arthroscopic knee surgery; intra-articular; ketorolac; nausea and vomiting; pain; sedation.

Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.

Postoperative pain is shown as VAS at rest during the first 24 hours after arthroscopic surgery. Data are presented as means ± SD. *Group ropivacaine and ketorolac versus group ropivacaine (p 

Figure 2.

Postoperative pain is shown as VAS at movement during the first 24 hours after arthroscopic surgery. Data are presented as means ± SD. *Group ropivacaine and ketorolac versus group ropivacaine (p 

Figure 3.

Postoperative sedative scale is shown according to the Ramsay Sedative Scale during the first 24 hours after arthroscopic surgery. Data are presented as means ± SD. *Group ropivacaine and ketorolac versus group ropivacaine (p 

Figure 4.

Postoperative nausea and vomiting scale is shown according to the Nausea and Vomiting Scale during the first 24 hours after arthroscopic surgery. Data are presented as means ± SD. *Group ropivacaine and ketorolac versus group ropivacaine (p