| The Analgesic Effect of Continuous Intraarticular Infusion of Ropivacaine and Fentanyl after Arthroscopic Shoulder Surgery. |
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Yong Kwan Cheong, Yong Son, Yoon Kang Song, Tai Yo Kim |
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Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University, Iksan, Korea. ykfolder@naver.com |
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| Abstract |
BACKGROUND
Arthroscopic shoulder surgery can result in moderate to severe postoperative pain. This study compared the postoperative analgesic effects of an intra-articular patient-controlled analgesia (PCA) infusion of 0.25% ropivacaine used with or without fentanyl after arthroscopic shoulder surgery.
METHODS
Sixty patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to three groups. After surgery, normal saline 21 ml (group 1; n = 20), and 0.25% ropivacaine 21 ml (group 2 and group 3; n = 20 respectively), was infused into the articular space through a PCA catheter, which was followed by an infusion of normal saline 99 ml (group 1), 0.25% ropivacaine 99 ml (group 2), or 0.25% ropivacaine 99 ml, including fentanyl 400microgram (group 3) through the intra-articular PCA catheter at 2 ml/hr with a bolus dose of 0.5 ml with a lock out time of 15 minutes. The level of pain was assessed using a visual analogue scale (VAS) and a verbal pain score (VPS) 2, 4, 6, 8, 12, 24 and 36 hours after the intra-articular bolus injection.
RESULTS
The pain scores were significantly lower after 2, 4, 6 hours in group 2 and 3 than in group 1. However, after 8 hours, the pain scores were significantly lower in group 3 than in the other two groups.
CONCLUSIONS
An intra-articular continuous infusion of 0.25% ropivacaine after arthroscopic shoulder surgery is more effective when used in conjunction with 400 microgram fentanyl. |
| Key Words:
fentanyl; ropivacaine; shoulder surgery; visual analogue scale; verbal pain score |
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