Intraarticular dexamethasone in pain management following arthroscopic Bankart repair

Abstract

Objective: Arthroscopic Bankart’s procedure is widely used method for shoulder instability. It may evoke
variable intensity of postoperative pain, which may be unbearable depending upon individual’s pain threshold.
Adequate pain relief reduces surgical stress response, improves postoperative recovery and rehabilitation.
We conducted this study to compare the postoperative analgesic effect of addition of dexamethasone
300 μg/kg to intra-articular ropivacaine with ropivacaine only in arthroscopic Bankart’s procedures.
Methodology: A prospective multi-center double blind study was conducted on 45 patients undergoing arthroscopic
Bankart’s procedure from Jan 2015 to June 2015. Patients were randomly assigned into 3 groups
- Group I receiving 20 ml normal saline, Group II 20 ml 0.2% ropivacaine and Group III (15 ml 0.2% of
ropivacaine and dexamethasone in a dose of 300 ug/kg intra-particularly. Variables assessed: analgesic effect
(VAS Score), time to first postoperative analgesic request, total analgesics used during first 24 hours.
Results: Group III had significantly low pain scores for more than 24 hours as compared to Group II and
Group I. Time to first analgesic requirement was the longest in Group III (1562.2 ± 79.10 min)(p < 0.01).
Intensity of pain and total analgesic requirement was also significantly less in Group III (32.2 ± 23.83 mg)
(p < 0.01) compared to Group II and I. No significant side-effects were noted.
Conclusion: Dexamethasone 300 μg / kg with ropivacaine intraarticularly has a superior analgesic efficacy, a
much prolonged postoperative pain relief, minimal postoperative analgesia requirement and better patient
compliance withnegligible side effects. Thus, we recommend dexamethasone 300 μg / kg in arthroscopic
Bankart’s procedure to facilitate early rehabilitation and good functional scores.