Intra-articular anesthesia. A systematic review

Authors

  • Alba Belén Beltrán Gallegos Hospital San Francisco de Quito. Universidad San Francisco de Quito. Pichincha.
  • Gissela Alejandra Fierro Díaz Hospital San Francisco de Quito. Universidad San Francisco de Quito. Pichincha.

Keywords:

surgery, anesthesia, intra-articular anesthesia, local anesthesia

Abstract

Introduction: rheumatic diseases, due to their natural evolution, bring with them affectations to the quality of life of the people carriers of the affections, reason why their early diagnosis, the opportune treatment and the prevention are of vital importance. The knowledge of contemporary advances in health care is a tool to help when making clinical decisions in daily practice, although the final decision on the diagnostic or therapeutic approach of a specific patient will depend on the characteristics of the same.
Objective: to carry out a systematic review of the specialized literature on intra-articular anesthesia.
Development: 56 articles were consulted between originals or research results, systematic reviews of the last 15 years, taking into account the publications related to intra-articular anesthesia published from 2007 to the present. Those articles or publications addressed to magazine directors or other documents that do not provide significant data were excluded. In addition, reports whose results did not correspond to the first and second level of evidence or were developed in animals were excluded.
Conclusions: research and evidence support the use of bupivacaine in its simple or combined form, which is the most commonly used, although the incorporation of a new local anesthetic with less toxicity, greater safety that does not affect cardiac function known as poiovacaine, is indicated. Opiates such as morphine and midazolam intra-articularly are the preferred local anesthetics for intra-articular interventions because of their analgesic effect in the postoperative period.

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Author Biographies

Alba Belén Beltrán Gallegos, Hospital San Francisco de Quito. Universidad San Francisco de Quito. Pichincha.

Doctora en Medicina. Residente de Postgrado de Anestesia.

Gissela Alejandra Fierro Díaz, Hospital San Francisco de Quito. Universidad San Francisco de Quito. Pichincha.

Doctora en Medicina General y Cirugía. Residente de Postgrado de de Anestesia.

References

Shaukat Y, Malik E, El-Khateeb H, Koeweiden E. The role of local anaesthesia in knee arthroscopy. journal of orthopaedics. 2013; 10(4): 193-195.

Tian J, Li Y. Comparative effects of vitamin C on the effects of local anesthetics ropivacaine, bupivacaine, and lidocaine on human chondrocytes. Revista brasileira de anestesiologia. [Internet]. 2016[citado 1 de febrero de 2018]; 66(1): 29-36. Disponible en: https://dx.doi.org/10.1016/j.bjane.2015.01.006

Zou Z, An Mao M, Xie Q, Chen Xiao Y, Zhang H, Liu Guan J. Single-dose intra-articular morphine for pain control after knee arthroscopy. Cochrane Database of Systematic Reviews. 2011; 5. Disponible en: DOI: 10.1002/14651858.CD008918.pub2

Senthilkumaran S, Tate R, Read JRM, Sutherland AG. Intra-articular morphine and bupivicaine for post-operative analgesia in anterior cruciate ligament reconstruction: a prospective randomised controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy. 2010; 18(6): 731-735.

Alagol AC¸ Alpur OU, Kaya G, Pamukc Z, Turan FN. The use of intraarticular tramadol for postoperative analgesia after arthroscopic knee surgery: a comparison of different intraarticular and intravenous doses. Knee Surg Sports Traumatol Arthrosc. 2004; 12:184-188. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/14691621

García Casalia A, Carradori G, Bollini C. Anestesia Intraarticular en la articulación de la rodilla. Rev. Arg. Anest. [Internet]. 2004[citado 1 de febrero de 2018]; 62, 6: 500-504. Disponible en: www.anestesia.org.ar/search/articulos_completos/1/1/813/c.pdf

Enríquez Vega ME. Lesión vascular en cirugía artroscópica de rodilla. s.n., Rev. Mex. Cir. 2013; 81, 5:454-458.

Kahlenberg CA, Patel RM, Knesek M, Tjong VK, Sonn K, Terry MA. Efficacy of celecoxib for early postoperative pain management in hip arthroscopy: a prospective randomized placebo-controlled study. Arthroscopy. 2017; 33(6): 1180-1185.

Karaoglu S, Dogru K, Kabak S, Inan M, Halici M. Effects of epinephrine in local anesthetic mixtures on hemodynamics and view quality during knee arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy. 2002;10(4): 226-228.

Marangoni LD, Giacossa R, Malvarez A, Bitar I, Bustos D, Galera H, Bertiche P. Anestesia raquídea versus anestesia intrarticular en cirugía artroscópica de rodilla. Revista de la Asociación Argentina de Ortopedia y Traumatología. 2016; 81(4): 258-263.

Aksu R, Bicer C, Ülgey A, Bayram A, Günes I, Güney A, Y•ld•r•m M, Gökahmetoglu G, Y•ld•z K. Comparación de bloqueo del plexo braquial por vía interescalénica y administración de anestésico local intraarticular en el manejo del dolor en el postoperatorio de cirugía artroscópica del hombro. Rev. Bras. Anest. [Internet]. 2015[citado 1 de febrero de 2018]; 6 (3). Disponible en: http://www.scielo.br/pdf/rba/v65n3/es_0034-7094-rba-65-03-00222.pdf

Hosseini H, Abrisham SMJ, Jomeh H, Kermani-Alghoraishi M, Ghahramani R, Mozayan MR. The comparison of intraarticular morphine•bupivacaine and tramadol•bupivacaine in postoperative analgesia after arthroscopic anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2012; 20(9):1839-1844.

Iamaroon A, Tamrongchote S, Sirivanasandha B, Halilamien P, Lertwanich P, Surachetpong S, Rungwattanakit P. Femoral nerve block versus intra-articular infiltration: a preliminary study of analgesic effects and quadriceps strength in patients undergoing arthroscopic anterior cruciate ligament reconstruction. J Med Assoc Thai. 2016; 99(5): 578-583.

Breu A, Rosenmeier K, Kujat R, Angele P, Zink W. The cytotoxicity of bupivacaine, ropivacaine, and mepivacaine on human chondrocytes and cartilage. Anesth Analg. 2013; 117, 514-22.

Sajedi P, Nemati M, Mosavi SH, Honarmand A, Safavi MR. A randomized controlled trial for the effectiveness of intraarticular versus intravenous midazolam on pain after knee arthroscopy. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2014; 19(5), 439.

Akhondzade R, Reza Pipelzade M, Sarrafan N, Mahmoodi K. Comparison of the analgesic effect of intra-articular and extra-articular injection of morphine and ketamine compound in arthrotomy lower limb surgery under spinal anesthesia. Pak J Med Sci. [Internet]. 2014[citado 1 de febrero de 2018]; 30(5): 942-945. Recuperado de: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163208/

Ruiz Valverde WE, Hidalgo Cisneros FM. Valoración del dolor postoperatorio en pacientes de 18 a 45 años de edad, sometidos a artroscopia de rodilla con anestesia local, atendidos en el servicio de Ortopedia y Traumatología del Hospital Metropolitano de Quito en el periodo agosto 2012 • agosto 2015. [Tesis de Especialidad] Universidad Central del Ecuador. Instituto Superior de Investigación y Postgrado. Quito, Ecuador; 2017.

Rocha da Silva R, Mato MA, Madureira G, Santos IGD. Comparative study of spinal and local anesthesia with propofol infusion for knee arthroscopy. Revista brasileira de ortopedia. 2012; 47(1): 108-112.

Gordon DB, de León-Casasola OA, Wu CL, Sluka KA, Brennan TJ, Chou R. Research gaps in practice guidelines for acute postoperative pain management in adults: findings from a review of the evidence for an American Pain Society Clinical Practice Guideline. J Pain. [Internet]. 2016[citado 1 de febrero de 2018];17:158•166. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26719073

Pinheiro LQ, Junior EN, Fernandes RM, Cardozo RT, Rezende PR. Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine. Revista Brasileira de Ortopedia (English Edition). 2015; 50(3): 300-304.

Chen X, Mou X, He Z, Zhu Y. The effect of midazolam on pain control after knee arthroscopy: a systematic review and meta-analysis. J Orthop Surg Res. 2017; 12: 179. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697077/

Centro colaborador de la Administración Nacional de Medicamentos, alimentos y Tecnología Médica (ANMAT). (s/f).VADEMECUM. [Internet]. 2017[citado 1 de febrero de 2018].Disponible en: http://www.iqb.es/cbasicas/farma/farma04/k006.htm

Isik C, Demirhan A, Yetis T, Oktem K, Sarman H, Tekelioglu UY, Duran T. Efficacy of intraarticular application of ketamine or ketamine•levobupivacaine combination on post-operative pain after arthroscopic meniscectomy. Knee Surgery, Sports Traumatology, Arthroscopy.2015; 23(9): 2721-2726.

Cuff DJ, O'Brien KC, Pupello DR, Santoni BG. Evaluation of factors affecting acute postoperative pain levels after arthroscopic rotator cuff repair. Arthroscopy. 2016; 32, 1231-1236. Disponible en: doi: 10.1016/j.arthro.2015.12.021

Tarlika P, Dalwadi D, Thakkar K, Singh P. Effectiveness of intra-articular dexmedetomidine as postoperative analgesia in arthroscopic knee surgery (A comparative study). IOSR Journal Of Pharmacy. 2015; 5(7): 18-27.

Arti H, Arti S. The Effects of Intraarticular Opioids in pain relief after arthroscopic menisectomy: A Randomized clinical trial study. Pak J Med Sci. 2013; 29: 625-8.

Published

2018-03-09

How to Cite

1.
Beltrán Gallegos AB, Fierro Díaz GA. Intra-articular anesthesia. A systematic review. Rev. cuba. de Reumatol. [Internet]. 2018 Mar. 9 [cited 2025 Dec. 6];20(2):e25. Available from: https://revreumatologia.sld.cu/index.php/reumatologia/article/view/618

Issue

Section

Review article