Objectives: Assessment the postoperative pain relieving effect of continuous intraarticular (IA) ropivacine/ tramadol infusion as against infusion of ropivacine alone after total knee arthroplasty.
Patients and Methods: Sixty patients with arthrosis were randomly assigned into three groups: Control group (group C), which didn't receive IA medications, Ropivacine group (group R), which received continuous IA infusion of ropivacine alone; and the combination group (group RT), which received a continuous IA infusion of ropivacine and tramadol at a rate of 6 ml /h for 72 h postoperatively. The IA infusion was delivered through multipored catheter for 72 h, postoperative pain was assessed using visual analogue pain scale (VAS), if the pain score was equal to or greater than 4, intravenous meperidine was administrated as supplementary analgesic. The total dose of analgesic supplementation, angle of knee joint flexion, and hospital stay length were recorded.
Results: Capacity to accomplish better degree of knee joint flexion was significantly higher in the combination group (group RT) compared with the other two groups, with significant better flexion infavour of the ropivacine group (group R) compared with the control group (group C). At 2h postoperatively, the mean pain score were significantly higher in the control group compared with patients who received IA analgesia and in the ropivacine group versus ropivacine/ tramadol group. The number of requests and total dose of analgesic requirements were significantly higher in the control group compared with patients who received IA analgesia and in the ropivacin group versus ropivacine / tramadol group. In the IA groups there was a positive significant correlation between angle of knee flexion and pain scores.
Conclusion: Continuous IA ropivacine / tramadol infusion safely decrease postoperative pain scores and analgesic requirement with significantly improved range of joint movement.
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