European Journal of Molecular & Clinical Medicine

Abstract

INTRODUCTION:intra-articular fractures of the lower limb are one of the most common fractures associated with knee stiffness. Even after an adequate and rigid fracture fixation early rehabilitation is necessary to drastically improve the outcome and reduce stiffness. Lack of effective pain control postoperatively can significantly reduce participation in therapy regimens and thus contribute to reaccumulation of fibrotic  tissue in the joint after artholysis. Hence, epidural anaesthesia through a lumbar epidural catheter is an established procedure to reduce post operative pain. 1 gm preservative free morphine and 2ml of 0.5 % Bupivacaine diluted with normal saline to make a total of 10 ml is the most commonly used protocol in top up after surgery for post operative analgesia.
MATERIALS AND METHODS:This is a prospective study. A total of 40 patients with peri-articular of distal femur and proximal tibia were included in the study. Patients were randomised into 2 groups. Group A was given spinal anaesthesia for surgery and Group B was given combined spinal plus epidural anaesthesia with a lumbar epidural catheter.
DISCUSSION: Main aim of medical science is to balance the wanted and unwanted effect optimally to provide patient safety as well as comfort and to facilitate rapid recovery and rehabilitation. Initial post-operative fear of pain  affects the rehabilitation after discharge because of constant fear of pain.There are several ananlgesic option for post operative pain managementDespite its widespread benefits epidural analgesia carries potential risks such a dural perforation, epidural hematoma and infection etc. pruritis, nausea, vomiting, urinary retention and respiratory depression are associated with epidural opioids but our study did not show any such complications