Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Table of Contents - Year : 2017 | Month : April | Volume : 11 | Issue : 4 | Page : UC13 - UC15

Analgesic Effect of Intra-articular Morphine or Dexmedetomidine Added with Levobupivacaine in Arthroscopic Knee Surgeries - A Comparative Evaluation UC13-UC15

Rajat Kumar Agarwal, Yashwant Singh Payal, Gaurav Chopra, Atul Agrawal

Correspondence
Dr. Yashwant Singh Payal,
Department of Anaesthesia, Himalayan Institute of Medical Sciences, SRH University, Dehradun-248140, Uttarakhand, India.
E-mail: dryspayal05@gmail.com

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 100g (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 (576.2067.09 minutes) followed by Group D (460.9338.95 minutes) and Group C (370.2758.80 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 (86.2527.48 mg) followed by group D (110.8744.48 mg) and group C (141.3544.13 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.