Abstract
Purpose: The purpose of this study was to compare the effectiveness of ropivacaine, a new
local amidic anesthetic, compared with morphine as an intra-articular drug in controlling
pain in patients after arthroscopic knee surgery. Type of Study: Randomized trial. Methods: We enrolled 90 patients scheduled to undergo elective knee arthroscopy. Patients
were homogenous regarding demographic data and ASA physical status. Procedures included
were diagnostic arthroscopies, lateral and medial meniscectomies, meniscal repair,
and removal of loose bodies. All cases were treated by the same surgeon, under general
anesthesia, using the same procedure. Patients were randomly divided into 3 groups.
The first group received ropivacaine 75 mg in 20 mL of saline solution, the second
group received 2 mg morphine in 20 mL of saline solution, and the third group received
20 mL of saline solution. No other oral or injectable analgesic administration was
allowed. A blind observer assessed the patients’ postoperative pain using a 10-cm
visual analogue scale (VAS), ranging from no pain (0) to unbearable pain (10). Scores
were taken at 0, 1, 4, 6, 12, and 24 hours after drug injection. VAS scores were analyzed
using analysis of variance; significance was set at P <.005. Results: None of the patients treated with ropivacaine or morphine needed administration of
any other oral or injectable analgesic. No adverse reaction was noted in ropivacaine
group. VAS score analysis in the first 4 postoperative hours showed greater effectiveness
for ropivacaine versus morphine or placebo with highly significant results (P <.001). In the first 24 postoperative hours, the ropivacaine group versus the morphine
group showed no significant differences (P =.207). Conclusions: Although its cost is very high compared with morphine, ropivacaine is a safe, site-specific,
and long lasting anesthetic drug with an earlier onset than morphine and almost the
same duration, covering the whole postoperative period (24 hours).
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 5 (May-June),
2001: pp 477–480
Keywords
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Article info
Footnotes
*Address correspondence and reprint requests to Francesco Franceschi, M.D., via E. Longoni 83, 00155 Roma, Italy. E-mail: [email protected]
Identification
Copyright
© 2001 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
