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ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 3  |  Page : 72-76

Comparative study of analgesic effects of intraarticular administration of equipotent dose of morphine and fentanyl with bupivacaine and bupivacaine alone in arthroscopic ACL reconstruction


1 Postgraduate Trainee, Department of Anesthesiology, Critical Care and Pain, RGK Medical College, Kolkata, West Bengal, India
2 Professor and Head, Department of Anesthesiology, Critical Care and Pain, RGK Medical College, Kolkata, West Bengal, India
3 Professor, Department of Orthopedics, RGK Medical College and Hospital, Kolkata, West Bengal, India
4 Assistant Professor
5 Associate Professor, Department of Anesthesiology, North Bengal Medical College, Kolkata, West Bengal, India
6 Professor, Department of Anesthesiology, Critical Care and Pain, RGK Medical College, Kolkata, West Bengal, India

Correspondence Address:
Dipasri Bhattacharya
Abhyudoy Housing, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10046-0046

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Intraarticular (IA) local anesthetics and opioids are often used for the management and prevention of pain after arthroscopic anterior cruciate ligament (ACL) reconstruction. In this study, analgesic efficacy of IA administration of equipotent dose of morphine and fentanyl with bupivacaine and bupivacaine alone in arthroscopic ACL reconstruction under spinal anesthesia has been compared. Forty-five patients, aged between 15 and 55 years, of American Society of Anesthesiologists (ASA) grade I and II were assigned into three equal groups (n = 15) in a randomized double-blind protocol. Group B received 20 mL of 0.25% bupivacaine and 1 mL normal saline (NS); group BF received 20 mL of 0.25% bupivacaine and 50 μg (1 mL) fentanyl; and group BM received 20 mL of 0.25% bupivacaine and 5 mg (0.5 mL) morphine and 0.5 mL NS through IA route at the end of the procedure. Postoperative analgesia was assessed by visual analogue scale (VAS) score. The VAS score in BM group was less during all the time in the postoperative period compared with the other two groups. This group also experienced longer duration of postoperative analgesia and lesser rescue analgesic. Intraarticular administration of morphine and bupivacaine is safe and provides prolonged analgesia with minimal side effects compared with bupivacaine and fentanyl and bupivacaine alone.


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