الفهرس | Only 14 pages are availabe for public view |
Abstract Arthroscopy of the knee has decreased morbidity compared with open incisions, however, it is usually associated with postoperative pain that may require systemic analgesia that can delay hospital discharge. Most of the intraarticular structures of the knee have free nerve endings and are capable of sensing painful stimuli and producing severe pain. Postoperative analgesia may be provided by using either systemic narcotic / nonnarcotic analgesic drugs or intraarticular local anaesthetics, NSAIDs (e.g. ketorolac) and opioids may provide significant pain relief following arthroscopic knee surgery.The goal of this study was to evaluate the effect of addition of fentanyl to ketorolac intraarticularly in arthroscopic knee surgery on the duration of postoperative analgesia. It was conducted on 40 adult patients of either sex admitted to Mansoura university hospital knee unit for elective knee arthroscopy and patients were randomly allocated into two equal groups ( 20 patients each ) :1) Ketorolac group (K) (n=20): in which patients received intraarticular 10 mg ketorolac diluted in 20ml of 0.9% saline. 2) Ketorolac Fentanyl group (KF) (n=20): in which patients received intraarticular 5 mg ketorolac + 50 (So(Bg fentanyl diluted in 20 ml 0.9% saline.All patients received general anaesthesia and all received the intraarticular study solution at the end of knee arthroscopy, ten minutes before release of the tourniquet. No any other analgesics were given during the operation. Every patient was monitored intraoperatively and postoperatively for 24 hours with ECG, non invasive blood pressure, pulse oximetry . Verbal Rating Score, duration of postoperative analgesia, postoperative analgesic consumption and postoperative complications (sedation, respiratory depression, pruritus , nausea and vomiting) were recoded postoperatively for 24 hours. In conclusion, this study revealed that the addition of fentanyl to intraarticular ketorolac significantly prolonges the duration of postoperative analgesia with no effects on haemodynamics and no increase in the incidence of side effects in patients undergoing arthroscopic knee surgery. |