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Jiangping W, Xiaolin Q, Han S, Zhou X, Mao N, Zhibo D, Ting G, Shidong H, Xiangwei L, Xin Y, Guoyin S. Network Meta-Analysis of Perioperative Analgesic Effects of Different Interventions on Postoperative Pain After Arthroscopic Shoulder Surgery Based on Randomized Controlled Trials. Front Med (Lausanne) 2022; 9:921016. [PMID: 35872801 PMCID: PMC9304654 DOI: 10.3389/fmed.2022.921016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundShoulder arthroscopic surgery is a common surgical method used in orthopedics. However, severe postoperative pain can significantly limit the early joint movement of patients and adversely affect the impact of the surgery. At present, there is no consistent and effective analgesic scheme for the management of postoperative pain after arthroscopic surgery of the shoulder.PurposeThe aim of this study was to search for the most effective analgesic scheme to control pain in the perioperative period of arthroscopic surgery of the shoulder.Study DesignNetwork meta-analysis.MethodsWe searched 5 different databases (i.e., Medline, PubMed, Embase, Web of Science, and the Cochrane Library) from January 2011 to January 2021 for English literature. Thereafter, we sifted out randomized controlled trials (RCTs), which compared different intervention schemes for pain management after shoulder arthroscopy and selected only 12 h, 24 h, or 48 h after the patient leaves the operating room as an optimal period for administration of analgesic intervention schemes. Only patients with shoulder disease who have undergone arthroscopic shoulder surgery were included in this study. The Cochrane “risk of bias” was used for the quality assessment. Moreover, some additional tests were performed to enhance the credibility of the results.ResultsTwenty-nine RCTs involving 1,885 patients were included in this frequentist network meta-analysis (NMA). These articles mainly were divided into two distinct groups, namely, the nerve block group and the non-nerve block group. Regarding the nerve block group, at postoperative 12 h, the intervention suprascapular nerve block + interscalene nerve block (SSNB + INB) was ranked first, whereas INB + intra-articular injection (INB + IAI) was ranked first at 24 h and 48 h postoperation. In the non-nerve block group, external application (EA) was ranked first at postoperative 12 h, but oral administration (OA) exhibited a better analgesic effect at postoperative 24 h and postoperative 48 h.ConclusionWe conclude that the analgesic effect of SSNB+INB was the best at postoperative 12 h, and INB+IAI was the best at postoperative 24 h and 48 h in the nerve block group. For the non-nerve block group, the effect of EA was the best at postoperative 12 h, and the analgesic effect of OA at postoperative 24 h and 48 h was significantly better than any other interventions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021286777.
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Affiliation(s)
- Wu Jiangping
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Quan Xiaolin
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Shu Han
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
- *Correspondence: Shu Han
| | - Xiaolan Zhou
- Medical Record Statistics Section, The Second Hospital of Chongqing Medical University, Chongqing, China
- Xiaolan Zhou
| | - Nie Mao
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Deng Zhibo
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Gong Ting
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Hu Shidong
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Li Xiangwei
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Yuan Xin
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
| | - Shu Guoyin
- Center for Joint Surgery, Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Clinical Research Center for Geriatrics and Gerontology, Chongqing, China
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Paul RW, Szukics PF, Brutico J, Tjoumakaris FP, Freedman KB. Postoperative Multimodal Pain Management and Opioid Consumption in Arthroscopy Clinical Trials: A Systematic Review. Arthrosc Sports Med Rehabil 2022; 4:e721-e746. [PMID: 35494281 PMCID: PMC9042766 DOI: 10.1016/j.asmr.2021.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- Ryan W. Paul
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, U.S.A
| | - Patrick F. Szukics
- Rowan University School of Osteopathic Medicine, Department of Orthopaedic Surgery, Stratford, New Jersey, U.S.A
| | - Joseph Brutico
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, U.S.A
| | | | - Kevin B. Freedman
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, U.S.A
- Address correspondence to Kevin B. Freedman, M.D., Rothman Orthopaedic Institute, Thomas Jefferson University, 825 Old Lancaster Rd., Suite 200, Bryn Mawr, PA, 19010, U.S.A.
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Xiang W, Jiang L, Shi L, Jiang C, Zhou Y, Yang C. The effect of magnesium added to bupivacaine for arthroscopy: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2021; 16:583. [PMID: 34629096 PMCID: PMC8504016 DOI: 10.1186/s13018-021-02609-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/30/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction The analgesic efficacy of magnesium sulphate added to bupivacaine for arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the efficacy of magnesium sulphate in combination with bupivacaine for arthroscopy. Methods We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through July 2020 for randomized controlled trials (RCTs) assessing the effect of magnesium sulphate plus bupivacaine versus bupivacaine for arthroscopy. This meta-analysis is performed using the random-effect model. Results Six RCTs were included in the meta-analysis. Overall, compared with bupivacaine for arthroscopy, combination analgesia using magnesium plus bupivacaine was associated with significantly prolonged duration of analgesia (SMD=0.93; 95% CI=0.27 to 1.60; P=0.006) and first time to analgesic requirement (SMD=196.57; 95% CI=13.90 to 379.24; P=0.03), reduced pain scores (SMD=-1.71; 95% CI=-2.96 to -0.46; P=0.007) and analgesic consumption (SMD=-1.04; 95% CI=-1.49 to -0.60; P<0.00001), but showed no remarkable influence on nausea or vomiting (OR=1.54; 95% CI=0.60 to 3.97; P=0.37). Conclusions Magnesium sulphate added to bupivacaine may significantly improve the analgesic efficacy for arthroscopy.
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Affiliation(s)
- Weineng Xiang
- Department of Spin Surgery, The First Hospital of Changsha, NO.311 Yingpan Road, Kaifu District, Changsha City, Hunan, China.
| | - Lin Jiang
- Department of Spin Surgery, The First Hospital of Changsha, NO.311 Yingpan Road, Kaifu District, Changsha City, Hunan, China.
| | - Langtao Shi
- Department of Spin Surgery, The First Hospital of Changsha, NO.311 Yingpan Road, Kaifu District, Changsha City, Hunan, China
| | - Chengming Jiang
- Department of Spin Surgery, The First Hospital of Changsha, NO.311 Yingpan Road, Kaifu District, Changsha City, Hunan, China
| | - Yun Zhou
- Department of Spin Surgery, The First Hospital of Changsha, NO.311 Yingpan Road, Kaifu District, Changsha City, Hunan, China
| | - Chunhua Yang
- Department of Spin Surgery, The First Hospital of Changsha, NO.311 Yingpan Road, Kaifu District, Changsha City, Hunan, China
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Different routes of co-administration of magnesium sulphate with spinal anesthesia in knee arthroscopy: Randomized controlled trial. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abdulatif M, Amin SMM, Aboul-Ela A, Samuel EWM, Abdel-Hakim SMA. Intra-articular versus intravenous magnesium-sulfate as adjuvant to femoral nerve block in arthroscopic knee surgery under general anesthesia: Randomized controlled trial. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2015.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Mohamed Abdulatif
- Department of Anesthesiology, Faculty of Medicine, Cairo University, Egypt
| | | | - Amina Aboul-Ela
- Department of Anesthesiology, Faculty of Medicine, Cairo University, Egypt
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Rasmussen JK, Nikolajsen L, Bjørnholdt KT. Acute postoperative pain after arthroscopic rotator cuff surgery: A review of methods of pain assessment. SICOT J 2018; 4:49. [PMID: 30465647 PMCID: PMC6250077 DOI: 10.1051/sicotj/2018042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 08/10/2018] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Pain can be severe during the first days after arthroscopic surgery, and acute pain is an important outcome in clinical trials of surgical technique or anaesthetic strategy. A standardized, validated method of assessing acute postoperative pain would improve the quality of clinical studies, and facilitate systematic reviews and meta-analyses. A step on the way towards this standard is to investigate the methods most commonly used in recent literature. METHODS PubMed and CINAHL databases were searched, including studies of arthroscopic rotator cuff surgery with a primary pain-related outcome during the first postoperative week, published in English from 2012 to 2017. RESULTS A total of 47 studies were included, all measuring pain intensity using a pain rating scale. Most frequently used was the visual analogue scale using the anchors "no pain" and "worst pain imaginable", with recordings at 1, 2, 4, 6, 8, 12, and 24 hours postoperatively. A total of 34 studies recorded analgesic consumption, usually as average cumulated consumption in mg. Time to first analgesic request or first pain were recorded in 11 studies, and 4 different starting points were used. DISCUSSION This review describes the currently most common methods of assessing acute postoperative pain in clinical trials of arthroscopic shoulder surgery involving rotator cuff repair, and the large variety of methods applied. Based on this study and international guidelines, several recommendations on how to measure and report postoperative pain outcomes in future trials are proposed.
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Affiliation(s)
| | - Lone Nikolajsen
- Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Research, C319, Palle Juul Jensens Boulevard 99, Aarhus, Denmark
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Bujalska-Zadrożny M, Tatarkiewicz J, Kulik K, Filip M, Naruszewicz M. Magnesium enhances opioid-induced analgesia – What we have learnt in the past decades? Eur J Pharm Sci 2017; 99:113-127. [DOI: 10.1016/j.ejps.2016.11.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/15/2016] [Accepted: 11/19/2016] [Indexed: 02/07/2023]
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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Xu X, Wen H, Hu Y, Liu Z, Pan X. Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty. Biomed Rep 2017; 6:232-236. [PMID: 28357078 DOI: 10.3892/br.2017.837] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/17/2016] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to compare the efficacy of intra-articular magnesium sulphate and a saline placebo for postoperative pain control following total hip arthroplasty (THA). Sixty patients underwent THA and were randomly allocated into two groups to receive intra-articular injections of either 10 ml magnesium sulphate (100 mg/ml; magnesium group, n=30) or 10 ml normal saline solution (control group, n=30). Postoperative analgesia was maintained by intravenous morphine injection. The outcome measurements were visual analogue score (VAS), morphine consumption and Harris hip score (HHS). The two groups were well matched. The outcome of VAS at rest was significantly lower at postoperative hours 6 and 12 in the magnesium group as compared with the control group, although the difference was insignificant preoperatively and at postoperative hours 2, 4, 24 and 48, and days 3, 7 and 14. This indicator during activity was also lower in the magnesium group at postoperative hour 24 than that of the control group, although the difference was insignificant preoperatively and at hour 48, and days 7 and 14. The consumption of morphine (the total quantity) at 0-6, 6-12 and 0-48 h in the magnesium group was significantly lower than in the control group, although no significant differences were observed at 12-24 and 24-48 h between the groups. The improvements of HHS from preoperative to postoperative scores were statistically significant, however, no significant differences were identified between groups. Thus, the findings indicate that intra-articular magnesium sulphate injections provided improved pain control and reduced the need for morphine when compared with a saline placebo following THA.
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Affiliation(s)
- Xinxian Xu
- Department of Osteopathy, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Hong Wen
- Department of Osteopathy, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Yuezheng Hu
- Department of Osteopathy, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Zhongtang Liu
- Department of Osteopathy, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Xiaoyun Pan
- Department of Osteopathy, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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Zeng C, Li YS, Wei J, Xie DX, Xie X, Li LJ, Gao SG, Luo W, Xiong YL, Xiao WF, Lei GH. Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis. Sci Rep 2016; 6:38024. [PMID: 27901095 PMCID: PMC5128786 DOI: 10.1038/srep38024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 11/03/2016] [Indexed: 12/17/2022] Open
Abstract
To examine the analgesic effect and safety of single-dose intra-articular (IA) magnesium (Mg) after arthroscopic surgery. Pubmed, Embase and Cochrane library were searched through in January 2016. Eight RCTs and eight experimental studies were included. The IA Mg exhibited a significantly lower pain score when compared with placebo (MD, -0.41, 95% CI, -0.78 to -0.05, p = 0.03). There was no significant difference between Mg and bupivacaine in terms of pain relief and the time to first analgesic request. Furthermore, statistically significant differences both in pain score (MD, -0.62, 95% CI, -0.81 to -0.42, p < 0.00001) and time to first analgesic request (MD, 6.25, 95% CI, 5.22 to 7.29, p < 0.00001) were observed between Mg plus bupivacaine and bupivacaine alone. There was no statistically significant difference among the various groups with respect to adverse reactions. Most of the included in vitro studies reported the chondrocyte protective effect of Mg supplementation. There were also two in vivo studies showing the cartilage protective effect of IA Mg. The single-dose IA Mg following arthroscopic surgery was effective in pain relief without increasing adverse reactions, and it could also enhance the analgesic effect of bupivacaine. In addition, Mg seemed to possess the cartilage or chondrocyte protective effect based on experimental studies.
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Affiliation(s)
- Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Yu-sheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
| | - Dong-xing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Xi Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Liang-jun Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Shu-guang Gao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Wei Luo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Yi-lin Xiong
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Wen-feng Xiao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Guang-hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
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Kundra S, Singh RM, Singh G, Singh T, Jarewal V, Katyal S. Efficacy of Magnesium Sulphate as an Adjunct to Ropivacaine in Local Infiltration for Postoperative Pain Following Lower Segment Caesarean Section. J Clin Diagn Res 2016; 10:UC18-22. [PMID: 27190924 DOI: 10.7860/jcdr/2016/17119.7683] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 01/17/2016] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Intravenous and peri-articular magnesium has been shown to reduce perioperative analgesic consumption. With this background, subcutaneous infiltration was hypothesized to potentiate the subcutaneous infiltration of local anaesthetic agent. AIM To comparatively evaluate the efficacy of magnesium sulphate as an adjunct to ropivacaine in local infiltration for postoperative pain following lower segment cesarean section. MATERIALS AND METHODS Sixty parturients undergoing cesarean delivery were randomized to either group A or B in a double blinded manner. After uterine and muscle closure but before skin closure, Group A was administered local subcutaneous wound infiltration of Injection (Inj) ropivacaine 0.75% 150 milligram (mg) or 20 millilitres(ml) whereas, group B patients were given a local subcutaneous wound infiltration of Inj magnesium sulphate 750 mg (1.5 ml of Inj 50% Magnesium sulphate) added to Inj ropivacaine 0.75% (18.5 ml) making a total volume of 20 ml. In postoperative period, Heart rate (HR), Mean Arterial Pressure (MAP), Visual Analogue Score (VAS), supplemental analgesic consumption and timing of each subsequent analgesic was noted for the initial 24 hours. RESULTS There was no difference in the timings for the requirement of first Intravenous (IV) rescue analgesic among both the groups (p=0.279). However, the need for 2(nd) and 3(rd) doses of rescue analgesics was significantly later in group B and the difference was statistically significant with p-value of 0.034 and 0.031 respectively. The number of patients who were administered 2(nd), 3(rd) and 4(th) doses of rescue analgesics was significantly greater in group A as compared to group B. None of the patients in group B needed more than 4 doses of rescue analgesia while in group A, 5 patients were administered a rescue analgesic for 5(th) time. The cumulative analgesic requirement in the initial 24 hours was also greater in group A as compared to group B and the difference was statistically significant (p =0.01). The incidence of adverse effects was similar in both the groups. CONCLUSION Subcutaneous infiltration of magnesium along with local anaesthetic prolongs the analgesic efficacy of local anaesthetic and is not associated with any significant adverse effects.
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Affiliation(s)
- Sandeep Kundra
- Associate Professor, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India
| | - Rupinder M Singh
- Professor, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India
| | - Gaganpreet Singh
- Resident, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India
| | - Tania Singh
- PG Resident, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India
| | - Vikrant Jarewal
- PG Resident, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India
| | - Sunil Katyal
- Professor and Head, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India
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INTRARTICULAR ANALGESICS FOLLOWING SHOULDER ARTHROSCOPY: COMPARISON OF ROPIVACAINE/DEXAMETHASONE WITH ROPIVACAINE. ACTA ACUST UNITED AC 2015. [DOI: 10.14260/jemds/2015/135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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