Comparison of Intra-articular 0.2% Ropivacaine versus 0.75% Ropivacaine in Acute Pain Treatment after Postoperative Knee Arthroscopy: A Randomized Control Trial

Abstract Context: In the realm of orthopedics, knee arthroscopy stands as a prevalent outpatient procedure. Despite the application of diverse pain alleviation techniques, the drawbacks frequently eclipse the advantages. Currently, there exists no consensus regarding the standard analgesic regimen following knee arthroscopy. At present, a unanimous agreement regarding the conventional analgesic regimen subsequent to knee arthroscopy remains elusive. Aims: The aim of the study was to evaluate the efficacy of administering 0.75% ropivacaine intra-articularly upon completion of knee arthroscopy for the management of postoperative pain. Settings and Design: A controlled, triple-blind clinical trial enrolled 70 participants scheduled for knee arthroscopic surgery due to simple acute meniscal tears and chondral injuries. Subjects and Methods: Following randomization, all participants received general anesthesia and a single intra-articular dose (10 mL of either 0.75% or 0.2% ropivacaine) at the conclusion of the surgical procedure. Pain intensity was assessed as “moderate-severe” using a Visual Analog Scale 2 h postropivacaine administration. Statistical Analysis Used: Chi-square and logistic regression analyses were employed for the primary objective. Results: In the intention-to-treat (ITT) analysis, with no loss of subjects, a significant difference was observed in the occurrence of moderate-to-severe pain between groups (Ropivacaine 0.2% [85.3%] vs. Ropivacaine 0.75% [27.8%], P < 0.001). According to the per-protocol analysis, which excluded 19 subjects requiring postsurgery opioids, moderate-to-severe pain was more prevalent in the ropivacaine 0.2% group (Ropivacaine 0.2% [77.3%] vs. Ropivacaine 0.75% [10.3%], P = 0.001). Conclusions: The utilization of intra-articular 0.75% ropivacaine following knee arthroscopy led to a reduced incidence of moderate-to-severe pain. The number needed to treat was 2 subjects, as demonstrated by both ITT and per-protocol analyses.