Comparison of intra-articular low-dose sufentanil, ropivacaine, and combined sufentanil and ropivacaine on post-operative analgesia of isolated anterior cruciate ligament reconstruction.

purposeTo evaluate the effect of combined local anaesthetic and opioid in post-operative analgesia, the effect of intra-articular injection of local anaesthetic (ropivacaine), opioid (sufentanil) and combination of these two (ropivacaine combined with sufentanil) after the single-bundle anterior cruciate ligament reconstruction were compared.

methodsIn a prospective randomized double-blind design, 80 patients who underwent isolated anterior cruciate ligament reconstruction under epidural analgesia were randomly allocated to 4 groups, group A (n = 20) received 30 mL of 0.9% saline as the control group, group B (n = 20) received 10 mg ropivacaine and 2 μg sufentanil in 30 mL 0.9% saline, group C (n = 20) received 10 mg ropivacaine in 30 mL 0.9% saline, group D (n = 20) received 2 μg sufentanil in 30 mL 0.9% saline at the end of the operation. Pain was assessed by use of a 100-mm visual analogue scale (VAS) which was evaluated at 6 and 24 h post-operation. The pain VAS score in active straight leg raising exercise, sleep quality and the status of the administered supplementary analgesia drugs during the first 24 h were also collected.

resultsPain scores of each of the three experiment groups were significantly lower than the control group in every aspect. Group B (ropivacaine with sufentanil) had significant lower pain score than group C (ropivacaine) and group D (sufentanil) both at 6 and 24 h after the operation. Patients in group B, C or D showed significant better sleep qualities than group A. Significantly more patients in group A received supplementary analgesia than group B, C or D. In group B, no patient needed to receive intramuscular dolantin as supplementary analgesia.

conclusionsIntra-articular injection of opioid (sufentanil), local anaesthetic (ropivacaine) or combination of these two kinds of agents could significantly reduce the pain following the reconstruction of anterior cruciate ligament. The combined intra-articular injection of opioid and local anaesthetic provided better analgesia effect than using sufentanil or ropivacaine alone. LEVEL OF EVIDENCE: Randomized controlled trial, Level I.