Post-operative analgesia for arthroscopic menisectomy by intra-articular, neostagmine, morphine and pethidine

ABSTRACT

Arthroscopic Surgery of the knee is a common day-case surgery depends on the provision of udequate analgesia. In this study sixcty pataients in similar age, weight, sex and duration of operation were allocated randomaly in four groups each of 15 both sex. The first [control group] received 30ml saline intra-articular, the second [morphine group] received 5mg morphine in 30ml saline,k the third [pethidine group] received 50mg pethidine in 30ml saline, and the fourth [neostagmine group] received 750ug neostagmine in 30ml saline. Above knee tournequet was applied for at least 10 minutes after intra-articular injection. Post-operative pain was assessed using an internal visual analogue scale [VAS] and measuring analgesic scale [VAS] and measuring analgesic requirements. All the three treated groups had highly significant lower pain scores compared with the control group. Patients in pethidine group had a significant lower pain scores than those in the morphine group up to 2 hours postoperative, but after that it had a significant increase pain scores than morphine group, also neostagnine group patients had significant lower pain score than morphine group up to 3 hours postoperatively after that it had a significant increase in pain score than morphine group but it had significant increase in pain score than pethidine up to 2 hours postoperative, after that a significant lower pain score than pethidine group. These exact findings explained by pethidine does its effect through its local anesthetic, peripheral opiate receptor systemic and active metabolite effects. Morphine does its effect through a peripheral opiate receptors and active metaboliotes Neostragmine has long lasting analgesic effect than morphine through a peripheral muscarinic respecters