Intrarticular analgesics following shoulder arthroscopy: comparison of ropivacaine/dexamethasone with ropivacaine

• Published in: Journal of evolution of medical and dental sciences p. 946
• Main Authors: Panigrahi, Ranajit, Mahapatra, Amita Kumari, Priyadarshi, Ashok, Palo, Nishit, Das, Dibya Singha, Biswal, Manas Ranjan
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 19.01.2015
• Subjects: Care and treatment; Dexamethasone; Dosage and administration; Pain; Shoulder surgery
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2015/135

INTRODUCTION: Shoulder arthroscopy is a common orthopedics procedure performed on day-case basis. Adequate pain relief reduces surgical stress response, patient's morbidity and improves postoperative recovery and rehabilitation. Various drugs have been tried intra-articularly to provide postoperative analgesia. PURPOSE: We studied analgesic effect of dexamethasone 16mg (4ml) with ropivacaine and compared it with ropivacaine intra-articularly in shoulder arthroscopic procedures in search of the ideal analgesic combination. METHODS: A Prospective Multicenter Double Blind study on 60 patients undergoing arthroscopic shoulder surgery from July'13- April'14. Patients were assigned into 3 groups randomly--Group I (20 ml normal saline),Group II (20 ml 0.2% ropivacaine) and Group III (16 ml 0.2% of ropivacaine & dexamethasone- 4 ml containing 16 mg. VARIABLES ASSESSED: Analgesic effect (VAS Score), time to first postoperative analgesic request, Analgesic used during first 24 hours. RESULTS: Group III had significant low pain scores for 1st 20 hours as compared to Group II and Group I. Time to first analgesic requirement was longest in Group III (1356.2[+ or -]193.10mins) (p<0.01). Intensity of pain &Total analgesic requirement was significantly less in Group III (38.2±27.83 mg)(p<0.01) in comparison to Group II and I. No significant side-effects were noted. CONCLUSION: A16 mg (4ml) dosage of Dexamethasone is safe, cost effective and free from relative side effects, has a better patient compliance in terms of post-operative pain, need for analgesia and should be used routinely in arthroscopic shoulder surgeries. Helps in the recovery of patients to the pre-operative level. KEYWORDS: Dexamethasone, Ropivacaine, pain relief, intra-articular, arthroscopic, shoulder surgery.