ABSTRACT
Postoperative pain is a common problem suffering the patients after knee surgery. Treatment with intra-articular corticosteroid preparation has been advocated but the value of this approach has not been established. We compared the efficacy of intra-articular dexamethasone plus bupivacaine with the efficacy of intra-articular bupivacaine alone to prevent post-operative pain after meniscectomy. Sixty ASAI patients undergoing meniscectomy with general anesthesia were randomly assigned to receive intra-operative intra-articular bupivacaine, bupivacaine plus dexamethasone, or placebo under double blinded condition. The group 1 [n=20] received 10ml of bupivacaine 0.5% with epinephrine 1 :2000000, group 2 [n=20] received 8ml bupivacaine 0.5% with epinephrine 1 :200000 plus 2ml [8mg] dexamethasone and group 3 [n=20] received 10ml of normal saline. The patients were evaluated until 12 hours after the operation and pain levels at rest measured by a Visual Analogue Scale [VAS]. During the first six hours after the operation, both combination of bupivacaine and dexamethasone and bupivacaine alone significantly reduced patient's pain [P=0.000] and during six to twelve hours after operation the patients in dexamethasone group had significantly lower pain scores comparing to the other group [P=0.037]. The low pain scores were associated with lower requirement of supplementary analgesics [P=0.000]. Combination of intra-articular dexamethasone and bupivacaine significantly reduces post-operative pain and consumption of analgesics following meniscectomy than intra-articular bupivacaine alone