Post-operative pain relief with intra-articular Bupivacaine alone and in combination with aqueous Diclofenac or Dexmedetomidine in patients undergoing arthroscopic anterior cruciate ligament reconstruction

Anterior Cruciate Ligament (ACL) injury is a very common problem of the knee, especially in athletes. Anterior Cruciate Ligament injury is a functionally disabling condition, also it is a common etiology of knee instability and dysfunction, and it also predisposes the knee for early onset of degenerative changes in the knee.

The aim of the treatment is to provide a stable joint which allows one to return to preinjury level of activity, improve knee-related quality of life, and avoid the late sequelae of an anterior cruciate ligament deficient knee. Anterior Cruciate Ligament reconstruction gives predictable and good results with various objective and subjective scores.

Post-operative pain is often encountered as a major obstacle delaying hospital discharge and preventing early rehabilitation. Systemic opioid and non-opioid agents have been tried previously for pain relief. It has been observed that through intraarticular injections a number of systemic adverse effects can be avoided. The most preferred local anesthetic is Bupivacaine, which has been reported to have higher success rates. Intra-articular administration of local anesthetics provides adequate but short-term analgesia. Hence, various adjuvant agents need to be added to the local anesthetics; among which opioids are the most used.

The aim of this study will be to compare the postoperative analgesic efficacy of intra-articular injection of bupivacaine alone vs when it will be combined with aqueous diclofenac or dexmedetomidine.