DOI: 10.14260/jemds/2015/135 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 4/ Issue 06/Jan 19, 2015 Page 946 INTRARTICULAR ANALGESICS FOLLOWING SHOULDER ARTHROSCOPY: COMPARISON OF ROPIVACAINE/DEXAMETHASONE WITH ROPIVACAINE Ranajit Panigrahi 1 , Amita Kumari Mahapatra 2 , Ashok Priyadarshi 3 , Nishit Palo 4 , Dibya Singha Das 5 , Manas Ranjan Biswal 6 HOW TO CITE THIS ARTICLE: Ranajit Panigrahi, Amita Kumari Mahapatra, Ashok Priyadarshi, Nishit Palo, Dibya Singha Das, Manas Ranjan Biswal. “Intrarticular Analgesics following Shoulder Arthroscopy: Comparison of Ropivacaine/Dexamethasone with Ropivacaine”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 06, January 19; Page: 946-952, DOI: 10.14260/jemds/2015/135 ABSTRACT: INTRODUCTION: Shoulder arthroscopy is a common orthopedics procedure performed on day-case basis. Adequate pain relief reduces surgical stress response, patient’s morbidity and improves postoperative recovery and rehabilitation. Various drugs have been tried intra-articularly to provide postoperative analgesia. PURPOSE: We studied analgesic effect of dexamethasone 16mg (4ml) with ropivacaine and compared it with ropivacaine intra-articularly in shoulder arthroscopic procedures in search of the ideal analgesic combination. METHODS: A Prospective Multicenter Double Blind study on 60 patients undergoing arthroscopic shoulder surgery from July’13- April’14. Patients were assigned into 3 groups randomly - Group I (20 ml normal saline),Group II (20 ml 0.2% ropivacaine) and Group III (16 ml 0.2% of ropivacaine & dexamethasone- 4 ml containing 16 mg. VARIABLES ASSESSED: Analgesic effect (VAS Score), time to first postoperative analgesic request, Analgesic used during first 24 hours. RESULTS: Group III had significant low pain scores for 1 st 20 hours as compared to Group II and Group I. Time to first analgesic requirement was longest in Group III (1356.2±193.10mins) (p<0.01). Intensity of pain &Total analgesic requirement was significantly less in Group III (38.2±27.83 mg)(p<0.01) in comparison to Group II and I. No significant side-effects were noted. CONCLUSION: A16 mg (4ml) dosage of Dexamethasone is safe, cost effective and free from relative side effects, has a better patient compliance in terms of post-operative pain, need for analgesia and should be used routinely in arthroscopic shoulder surgeries. Helps in the recovery of patients to the pre-operative level. KEYWORDS: Dexamethasone, Ropivacaine, pain relief, intra-articular, arthroscopic, shoulder surgery. INTRODUCTION: Shoulder surgery can be very painful and interscalene brachial plexus block is the gold standard in the management of acute pain after shoulder surgery. Increasingly, trend is shifting towards day care surgeries especially in arthroscopic and mini-open shoulder procedures 1 to enhance the patient compliance and facilitate early return to home. However, these surgeries evoke different levels of pain which at times can be unbearable depending on the patient’s pain tolerance. Post-operative pain has negative impact on patient’s psychology, mobilisation and rehabilitation which may lead to a prolonged hospital stay 2 and affect the prognosis. Adequate pain relief reduces the surgical stress response and improves postoperative recovery and rehabilitation. 2 There has always been a search for a simple method for providing postoperative analgesia in these patients that have a prolonged duration of action, easy to administer and should be without any serious side effects. Utilizing the peripheral receptors for postoperative pain management is an important mode of such an approach. The intra-articular route of drug administration utilises the