Observational study of ropivacaine and compound betamethasone mixture for analgesia after triangular fibrocartilage complex repair under wrist arthroscopy: A single-center randomized double-blind controlled trial

Xinzhu Wang; Yansheng Wang; Ning Yu; Hui Xu; Zeming Lei

doi:10.1016/j.jos.2023.08.017

Observational study of ropivacaine and compound betamethasone mixture for analgesia after triangular fibrocartilage complex repair under wrist arthroscopy: A single-center randomized double-blind controlled trial

J Orthop Sci. 2023 Oct 18:S0949-2658(23)00256-7. doi: 10.1016/j.jos.2023.08.017. Online ahead of print.

Authors

Xinzhu Wang¹, Yansheng Wang¹, Ning Yu¹, Hui Xu¹, Zeming Lei²

Affiliations

¹ Hand Surgery 5 Ward, Central Hospital Affiliated to Shenyang Medical College. No. 5, Nanqi West Road, Tiexi District, Shenyang City, Liaoning Province, China.
² Hand Surgery 5 Ward, Central Hospital Affiliated to Shenyang Medical College. No. 5, Nanqi West Road, Tiexi District, Shenyang City, Liaoning Province, China; Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University. No. 36, Sanhao Street, Heping District, Shenyang City, Liaoning Province, China. Electronic address: leizem@163.com.

PMID: 37863682
DOI: 10.1016/j.jos.2023.08.017

Abstract

Background: The purpose of this study was to investigate the clinical effect of an intra-articular and local infiltration injection of a compound analgesic mixture of ropivacaine and compound betamethasone on the repair of the triangular fibrocartilage complex under wrist arthroscopy.

Methods: This prospective, double-blind, randomized study involved 20 patients with Atzei type 2 or 3 injuries of the triangular fibrocartilage complex who underwent repair under wrist arthroscopy. Patients were divided into two groups (n = 10) according to the systematic random sampling method. The test group was injected with a "cocktail" mixture for pain relief. The control group was injected with normal saline. The visual analog scale (VAS) pain score, pinch force, wrist joint mobility, wrist joint function score (PRWE score), occurrence of adverse reactions and dosage of analgesic drugs were evaluated before and after the operation in the two groups.

Results: The resting pain of the patients in the test group was less severe than that of the control group at 12 h, 24 h and 48 h after the operation (P < 0.05), and the pinch force of the patients in the test group was significantly greater than that of the control group at 1 d, 2 d and 3 d after the operation (P < 0.01). The amount of postoperative analgesics used in the test group was significantly lower than that in the control group (P < 0.01), and the patient satisfaction rate in the test group was higher than that in the control group (P < 0.05). There were no postoperative adverse effects in either group.

Conclusion: An intra-articular and local infiltration injection of a "cocktail" analgesic mixture in the repair of triangular fibrocartilage complex under wrist arthroscopy can provide good pain control in the early postoperative period and reduce the amount of postoperative analgesic drugs administered, thus improving clinical safety.

Level of evidence: Level II; Randomized Controlled Trial; Treatment Study.

Keywords: Analgesia; Cocktail; Triangular fibrocartilage complex; Wrist arthroscopy.