Canadian Journal of Anesthesia

, Volume 52, Issue 8, pp 832–836

Un mélange de bupivacaïne et de kétamine est supérieur à la kétamine seule pour ľanalgésie intra-articulaire à la suite ďune arthroscopie du genou

  • Yatindra Kumar Batra
  • Rajesh Mahajan
  • Sushil Kumar Bangalia
  • Onkar Nath Nagi
  • Mandeep Singh Dhillon
Article

Résumé

Objectif

Ľadministration centro-neuraxiale et parentérale de kétamine peut produire une analgésie, limitée toutefois par des effets indésirables. Nous avons voulu vérifier la qualité de ľanalgésie selon ľutilisation de kétamine seule ou en combinaison avec de la bupivacaïne à la suite ďune arthroscopie du genou.

Méthode

Soixante patients, ďétat physique ASA I ou II, devant subir la réparation arthroscopique ďun ménisque sous anesthésie générale, ont été répartis au hasard pour recevoir 1,0 mg·kg-1 de kétamine (Groupe K), de la bupivacaïne à 0,25 % (Groupe B) ou une combinaison de 1,0 mg·kg-1 de kétamine et de bupivacaïne à 0,25 % (Groupe BK) dans un volume total de 20 mL administré par voie intra-articulaire après ľopération. Les scores de ľéchelle visuelle analogique 0,5, 1, 2, 4, 6, 8, 12 et 24 h après ľopération, la durée de ľanalgésie et les analgésiques supplémentaires pendant 24 h de plus (dextroproxyphène/acétaminophène) ont été enregistrés.

Résultats

Les scores de douleur ont été significativement plus élevés chez les patients du Groupe K, comparé aux Groupes B et BK. La durée de ľanalgésie a été plus courte aussi dans le Groupe K (Groupe B = 5,7 ± 0,8 ; Groupe BK = 5,1 ± 1,1 vs GroupeK = 1,7 ± 0,9 h ; P < 0,05).La consommation ďanalgésique supplémentaire a toutefois été similaire dans les trois groupes.

Conclusion

Ľadministration intra-articulaire ďune combinaison de bupivacaïne et de kétamine fournit une meilleure analgésie que la kétamine seule après une arthroscopie du genou en chirurgie ďun jour.

Bupivacaine/ketamine is superior to intra-articu-lar ketamine analgesia following arthroscopic knee surgery

Abstract

Purpose

Centroneuraxial and parenteral administration of ketamine has been shown to produce analgesia. However, this analgesia is limited by adverse effects. The purpose of this study was to determine whether ketamine alone or in combination with bupivacaine provides superior pain relief after surgery in patients undergoing knee arthroscopy.

Methods

Sixty patients (classified as ASA status I or II) undergoing arthroscopic meniscus repair during general anesthesia were randomized to receive 1.0 mg·kg-1 ketamine (Group K), 0.25% bupivacaine (Group B) or a combination of 1.0 mg·kg-1 ketamine and 0.25% bupivacaine (Group BK) to a total volume of 20 mL by intra-articular route following surgery. Visual analogue score in the postanesthesia care unit at 0.5, 1, 2, 4, 6, 8, 12 and 24 hr after surgery, duration of analgesia and subsequent 24 hr consumption of rescue analgesic (dextroproxyphene/ acetaminophen) were evaluated.

Results

The results showed significantly higher pain scores in Group K as compared to Group B and Group BK. The duration of analgesia was significantly shorter in Group K as compared to the other two groups (Group B = 5.7 ± 0.8; Group BK = 5.1 ± 1.1 vs Group K = 1.7 ± 0.9 hr; P < 0.05). However, 24 hr consumption of analgesic was similar in the three groups.

Conclusion

We conclude that intra-articular bupivacaine-ket-amine combination provides better pain relief than intra-articu-lar ketamine after day care arthroscopic knee surgery.

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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  • Yatindra Kumar Batra
    • 1
  • Rajesh Mahajan
    • 1
  • Sushil Kumar Bangalia
    • 1
  • Onkar Nath Nagi
    • 2
  • Mandeep Singh Dhillon
    • 2
  1. 1.Department of Anesthesia and Intensive CarePostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  2. 2.Department of Orthopedic SurgeryPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

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