A study to compare the analgesic efficacy of intra-articular Levobupivacaine, Fentanyl and Clonidine following arthroscopic knee surgery

Abstract

Arthroscopic knee surgery can produce pain postoperatively which can be very distressing. Many drugs, in various ways, have been tried to overcome this pain. But none found to be most effective. So we have done a study for correlating with the analgesic levobupivacaine efficiency, fentanyl, & clonidine into intra-articular therapy associated with arthroscopic surgeries. This study was conducted from Nov 2019 to April 2020, in which 90 patients undergoing arthroscopic surgery of knee split in 3 classes of 30 each. (L,F,C). Class L was injected 10 millilitre in levobupivacaine of 0.26% e, where Class F was injected 50 mcg fentanyl, and Class C was injected 50 mcg of clonidine in intra-articular therapy after surgery. Time of first analgesia request, no of the analgesic dose required and total rescue analgesic required in postoperative 24 hours were assessed. The pain was assessed using a visual analogue scale. Demographic characteristics were similar among all the three Class. Time for the need of 1st analgesic request in Class L was 381.57 ± 24.63 min, in Class F was 328.67 ± 20.42 min and in Class C was 238.47 ± 21.93 minutes. (p<0.06) The overall amount of doses of analgesic needed was fewer in Class L (1.21 ± 0.57) in comparison to Class F (1.95 ± 0.42) and Class C (2.12 ± 0.34). (p<0.05) A total dose of paracetamol used was reduced in Class L correlated with Class F and C in 1^st 24 hrs postoperatively. (p<0.05) Class F & C has a highest average score of VAS at various time points in 1^st 24 hrs correlated with Class L. (p<0.05) Intra-articular levobupivacaine obtained better control of pain in the postoperative period with a delayed time of need of 1^st analgesic dose and reduced the need of a total dose of rescue analgesic in comparison to intra-articular clonidine and fentanyl.