Abstract

Introduction: Pain is constant companion for human. There is perhaps nothing as dreaded as pain. Pain is the ultimate teacher. It alerts the body to disease. Depending upon the intensity and duration, it impacts quality of life. Pain after total knee arthroplasty (TKA) is a big concern in orthopaedics. Although opioids and continuous epidural analgesia remains the major option for the postoperative pain management of TKA, they have undesirable side effects like sedation, nausea and hypotension.  Epidural catheterization is skilful and technically demanding procedure with close monitoring. Infiltration of local anesthetic solution minimizes pain at the source superiorly. It has short learning curve, no systemic side effects, no infection, level of motor block is none, early mobilization and cost effective. There is not much study done on combination of Ropivacaine and Clonidine as a LIA.
Material and Methods: A prospective study was carried out among 30 cases undergoing total knee surgery at a tertiary care hospital. During pre-anaesthetic check up detailed assessment of airway, respiratory and cardiovascular system was carried out. Basic laboratory data were reviewed. Informed consent was taken. All patients were kept nil per oral for 8 hours and were pre-medicated with Tab Ranitidine 150mg, Tab Diazepam 5mg orally 12 hours before surgery. Patients were taught the visual analog pain scale (VAS) (0 = no pain, 10 = worst imaginable pain), and VAS was measured preoperatively at rest and on movement of the knee to be operated.
Results: We observed that; mean age was 62.7+9.9 years. Out of 30, 70% were female and 30% were males. Pain control with Ropivacaine and clonidine has been very effective in 1st 24 hours in total knee replacement surgery.
Conclusion: From this study s we concluded that, with the use of local infiltrative anesthesia i.e combination of Ropivacaine & clonidine, requirement of opioid has been decreased. Effects on cardiovascular system like tachycardia, hypertension has also been decreased. It also benefited patient by early mobilization.