Sivapurapu V, et al. - This study investigated the added advantage of intra-articular administration of morphine or clonidine combined with bupivacaine, compared with bupivacaine alone, in patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR) under spinal anesthesia. Intra-articular administration of bupivacaine plus clonidine provided a longer duration of analgesia, though the quality of analgesia provided by morphine + bupivacaine, clonidine + bupivacaine and, bupivacaine alone, was comparable.

Methods

• Researchers obtained approval of the Institute Ethics Committee and randomly assigned 90 American Society of Anesthesiology I-II patients, undergoing arthroscopic ACLR under spinal anesthesia, to one of three groups (Group B – bupivacaine alone 0.25%, Group BM – bupivacaine 0.25% with morphine 5 mg, Group BC – bupivacaine 0.25% with clonidine 150 mcg).
• At the end of procedure, 20 mL of the respective drug was administered intra-articularly and postoperative time duration to rescue analgesia, 24 h analgesic requirement, visual analog scale (VAS) score findings at rest and on movement were observed.

Results

• Findings demonstrated that the mean duration of time to request for first rescue analgesia in minutes was significantly longer in Group BC 341.55 (103.66 SD) with P <0.001.
• Researchers observed that the VAS scores at that time point were least in Group BM 6.1 (1.7 SD), but not statistically significant.
• They also noted that the 24 h analgesic consumption was least in Group B 2.24 (0.79 SD), but not statistically significant.