RESUMO
The effective relief of postsurgical pain in patients undergoing knee arthroscopy is important to allow the initiation of activities of daily living. The objective of this study is to demonstrate the analgesic efficacy of dexmedetomidine as an adjuvant added to ropivacaine by the intra-articular route. METHOD: Seventy patients underwent knee arthroscopy which were randomly assigned into two groups (n=35). The RD group received ropivacaine 1.5mg/kg plus dexmedetomidine 1µg/kg intra-articularly. Group R received ropivacaine 1.5mg/kg intra-articularly. The analgesic effect was evaluated by measuring the intensity of pain (VAS score) and the duration of analgesia. RESULTS: A longer duration of the analgesic effect was observed in the RD group (655min) compared to the R group (318min) being statistically significant (p=0.03). CONCLUSION: Dexmedetomidine as an adjuvant to intra-articular ropivacaine improves the quality and duration of postoperative analgesia in patients undergoing knee arthroscopy.
RESUMO
For the past two decades arthroscopic surgery has revolutionized the treatment of acute traumatic knee injuries with patients returning sooner to activities of daily living. However, there are factors that delay this goal, such as postoperative intraarticular bleeding, and the swelling and pain that restrain immediate articular mobility. This paper analyzes such factors and their pathophysiologic processes. This led us to formulating a preparation for intraarticular use called RV023. The report of an original, prospective, longitudinal trial is presented herein, assessing the functional results of preparation RV023 in a 60-patient sample selected based on the following inclusion criteria: knee pain lasting 2 years and unresponsive to NSAID treatment, an MRI showing an Outerbridge grade I chondral injury without evidence of ligament or meniscal injury or fracture, and having undergone arthroscopic knee surgery. A significant difference was found in the articular function of subjects treated with the preparation as compared with those in whom it was not used. The articular function recovery curves of individuals treated with the preparation were virtually symmetrical to the curves for healthy controls. On the other hand, no allergic reactions, unwanted or side effects were reported. We therefore conclude that the safety and the benefits seen with preparation RV023 in experimental models are enough to support its use in humans.
Assuntos
Artroscopia , Ácido Hialurônico/administração & dosagem , Articulação do Joelho/cirurgia , Adulto , Combinação de Medicamentos , Feminino , Hospitais , Humanos , Injeções Intra-Articulares , Masculino , México , Cuidados Pós-Operatórios , Estudos ProspectivosRESUMO
OBJECTIVE: To evaluate the experience acquired in hallux valgus correction with percutaneous distal metatarsal osteotomy. MATERIAL AND METHODS: Retrospective study including patients who underwent percutaneous distal metatarsal osteotomy between May 2005 and May 2007. The age, sex, and number of feet operated on were recorded. The clinical evaluation of results 6 months after surgery using the AOFAS scale, the intermetatarsal angle and the hallux valgus angle were also recorded. RESULTS: A total of 40 patients were included; 38 females and 2 males; mean age was 49 years (28-73 years). Fifty-eight osteotomies were performed. According to the AOFAS scale, 28 patients (41/58 feet) had no pain. The mean functional capacity score was 41 points, and an excellent alignment was achieved in 74% of cases. The mean intermetatarsal angle was 7.5 degrees. Complications occurred in 2 patients (2 feet). CONCLUSIONS: The appropriate treatment for the correction of hallux valgus consists of minimally invasive procedures, except for the cases in which the metatarsophalangeal joint shows signs of arthrosis.