EFFICACY OF INTRA-ARTICULAR KETOROLAC AND LIGNOCAINE ON POST-OPERATIVE PAIN RELIEF AFTER ARTHROSCOPIC KNEE SURGERY

Authors

  • Auon Shabbir Khan Niazi Combined Military Hospital, Rawalpindi
  • Mubashar Ahmed Bajwa Combined Military Hospital, Rawalpindi
  • Midhat Zahra Combined Military Hospital, Rawalpindi
  • Muhammad Uzair Khan Niazi Foundation Univeristy Medical College, Rawalpindi
  • Irta Zainab CIMS, Multan
  • Adnan Anwer Combined Military Hospital, Rawalpindi

DOI:

https://doi.org/10.55519/JAMC-02-8647

Abstract

Background: Arthroscopy of the knee is preferably done under spinal anaesthesia. The optimal analgesia for effective postoperative pain control is important to permit early discharge, comfort and mobility of the patient. Objective of the study is to assess the efficacy of ketorolac and lignocaine administered intra-articularly for postoperative pain following knee arthroscopic surgery. Methods: A total of 133 patients were randomized into two groups with one group receiving intra-articular Ketorolac and the other group receiving intra-articular Lignocaine. Postoperative pain was then assessed using the Visual Analog Scale (VAS) at 4, 8, 12 and 24 hours after surgery. Result: Both the groups had effective analgesia at 4 hours. The best analgesia was seen in the group that received Ketorolac Intra-articularly and it was found statistically significant. Conclusion: Administration of intra-articular Ketorolac injection is safe and effective way of achieving postoperative pain relief after arthroscopic knee surgery.

Author Biography

Auon Shabbir Khan Niazi, Combined Military Hospital, Rawalpindi

Orthopedic Surgery, Resident

References

Ng HP, Nordström U, Axelsson K, Perniola AD, Gustav E, Ryttberg L, et al. Efficacy of intra-articular bupivacaine, ropivacaine, or a combination of ropivacaine, morphine, and ketorolac on postoperative pain relief after ambulatory arthroscopic knee surgery: a randomized double-blind study. Reg Anesth Pain Med 2005;31(1):26–33.

Vane JR. Mode of action of aspirin and similar compounds. New York, Raven Press: 1974; p.155–63.

Møiniche S, Mikkelsen S, Wetterslev J, Dahl JB. A systematic review of intra-articular local anesthesia for postoperative pain relief after arthroscopic knee surgery. Reg Anesth Pain Med 1999;24(5):430–7.

Gupta A, Bodin L, Holmström B, Berggren L. A systematic review of the peripheral analgesic effects of intraarticular morphine. Anesth Analg 2001;93(3):761–70.

Reuben SS, Connelly NR. Postoperative analgesia for outpatient arthroscopic knee sugery with intraarticular bupivacaine and ketorolac. Anesth Analg 1995;80(6):1154–7.

Higgs GA, Eakins KE, Moncada S, Vane JR. Arachidonic acid metabolism in inflammation and the mode of action of anti-inflammatory drugs. Agents Actions Suppl 1979(6):167–75.

Higgs GA, Vane JR, Hart FD, Wojtulewski JA. Effects of anti-inflammatory drugs on prostaglandins in rheumatoid arthritis. New York, Raven Press: 1974; p.165–73.

Reuben Ss Fau - Connelly NR, Connelly NR. Local analgesia effect of nonsteroidal antiinflammatory drugs. Anesth Analhg 1997;84(5):1168–9.

Gupta A, Axelsson K, Allvin R, Liszka-Hackzell J, Rawal N, Althoff B, et al. Postoperative pain following knee arthroscopy: the effects of intra-articular ketorolac and/or morphine. Reg Anesth Pain Med 1999;24(3):225–30.

Reuben SS, Connelly NR. Postarthroscopic meniscus repair analgesia with intraarticular ketorolac or morphine. (0003-2999 (Print)).

Chirwa SS, MacLeod BA, Day B. Intraarticular bupivacaine (Marcaine) after arthroscopic meniscectomy: a randomized double-blind controlled study. Arthroscopy 1989;5(1):33–5.

Henderson RC, Campion ER, DeMasi RA, Taft TN. Postarthroscopy analgesia with bupivacaine. A prospective, randomized, blinded evaluation. Am J Sports Med 1990;18(6):614–7.

Craft DV, Good RP. Delayed hypersensitivity reaction of the knee after injection of arthroscopy portals with bupivacaine (marcaine). Arthroscopy 1994;10(3):305–8.

Hasselstrøm LJ, Mogensen T. Toxic reaction of bupivacaine at low plasma concentration. Anesthesiology 1984;61(1):99–100.

Adverse reactions with bupivacaine. FDA Drug Bull 1983;13(3):23.

Stein C, Hassan AH, Lehrberger K, Giefing J, Yassouridis A. Local analgesic effect of endogenous opioid peptides. Lancet 1993;342(8867):321–4.

Raja SN, Dickstein RE, Johnson CA. Comparison of postoperative analgesic effects of intraarticular bupivacaine and morphine following arthroscopic knee surgery. Anesthesiology 1992;77(6):1143–7.

Ruwe PA, Klein I, Shields CL. The effect of intraarticular injection of morphine and bupivacaine on postarthroscopic pain control. Am J Sport Med 1995;23(1):59–64.

Kalso E, Tramèr MR, Carroll D, McQuay HJ, Moore RA. Pain relief from intra-articular morphine after knee surgery: a qualitative systematic review. Pain 1997;71(2):127–34.

Jaureguito JW, Wilcox JF, Cohn SJ, Thisted RA, Reider B. A comparison of intraarticular morphine and bupivacaine for pain control after outpatient knee arthroscopy. A prospective, randomized, double-blinded study. Am J Sport Med 1995;23(3):350–3.

Downloads

Published

2022-03-03