Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Randomized Controlled Trial Clinical Trial
Analgesic effects of intraarticular bupivacaine after day-case arthroscopy.
A blind, prospective, randomized, controlled trial was conducted to assess the analgesic properties of intraarticular bupivacaine after day-case arthroscopy. Forty-eight patients undergoing routine arthroscopy were randomly allocated to receive 10 ml of 0.5% bupivacaine or 0.9% saline into the joint at the end of the procedure. The analgesic effects were assessed by visual analogue scales at discharge, on going to bed, and the following morning. Significant reduction in reported pain was found in the treatment groups on leaving the hospital and later the same evening, although no benefit was found the following day.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic effect of intraarticular morphine, bupivacaine, and morphine/bupivacaine after arthroscopic knee surgery.
In a double-blind randomized fashion, 38 patients were divided into four groups according to the intraarticular injection received after arthroscopic surgery. Patients in group I (n = 7) received saline, group II (n = 10) morphine, group III bupivacaine, and group IV (n = 11) morphine and bupivacaine. Before surgery and at 0.5, 1, 1.5, 2, 6, and 24 h postoperatively, pain levels were recorded. ⋯ Although there was a statistically significant difference in pain scores between the saline group and the other three groups during the early postoperative period, there was no significant difference in pain scores between the morphine, bupivacaine, and morphine/bupivacaine groups. We conclude that postoperative, intraarticular injection of analgesics is beneficial in reducing pain levels. The combination of morphine/bupivacaine appears to be the most beneficial analgesic due to its low supplemental analgesic requirements postoperatively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pain relief after arthroscopic surgery of the knee: a prospective, randomized, and blinded assessment of bupivacaine and bupivacaine with adrenaline.
A prospective, randomized, and double-blind study was conducted to compare the influence on postoperative pain of equal volumes of saline, bupivacaine, or bupivacaine with adrenaline, injected both intraarticularly and into the wound puncture site, for 118 day case patients undergoing elective knee arthroscopy. Marginal analyses of postoperative visual analogue pain scores and postoperative fentanyl doses showed that the group given bupivacaine with adrenaline had less postoperative pain when compared with the saline group. However, when multifactor analyses were performed, preoperative visual analogue pain scores, operation type and length, and the sex of the patient were all shown to be significant predictors of postoperative pain, but the use of bupivacaine was not. We conclude that the observed differences in postoperative pain were due to differences between the groups in these predictive factors, especially preoperative pain scores, and that the use of bupivacaine was less important and not statistically significant in influencing postoperative pain.
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Randomized Controlled Trial Clinical Trial
The clinical effect of naproxen sodium after arthroscopy of the knee: a randomized, double-blind, prospective study.
The aim of this study was to examine the clinical effect of naproxen sodium after knee arthroscopy. The design was randomized, prospective, and double-blind, with a placebo control group. Patients with preoperative synovial reaction were excluded. ⋯ In patients who had undergone diagnostic arthroscopy naproxen sodium demonstrated a beneficial effect on pain (p < 0.01). At 20 days' follow-up, in the operative group naproxen sodium affected synovial effusion (p < 0.05), range of motion (p < 0.01) and pain (p < 0.05), and walking activity (p < 0.05). No effect was seen in the diagnostic group at 20 days' follow-up.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bupivacaine use after knee arthroscopy: pharmacokinetics and pain control study.
Bupivacaine (Marcaine) pharmacokinetics were determined in 11 patients receiving the drug intraarticularly after arthroscopic procedures performed on the knee with patients under general anesthesia. Forty milliliters of 0.25% bupivacaine (100 mg) were given as a bolus into the intraarticular space of the knee of each patient. The thigh tourniquet was released 2-3 min after injection and blood samples were obtained 5, 10, 15, 20, 30, 60, 120, 180, 250, and 300 min after tourniquet release. ⋯ Peak levels can be minimized with shorter tourniquet inflation times and with longer injection to tourniquet release intervals. Ninety healthy adult outpatient knee arthroscopy patients also were studied to evaluate the effectiveness of bupivacaine in relieving postoperative knee discomfort when injected immediately postoperatively. The subjects were randomized into four groups: (a) intraarticular injection of saline, (b) intraarticular injection of bupivacaine, (c) subcutaneous injection of bupivacaine at the portal sites, and (d) both intraarticular and subcutaneous injection of bupivacaine.(ABSTRACT TRUNCATED AT 250 WORDS)