• Title/Summary/Keyword: intra-articular

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Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial

  • Ismail, Eman A.;Sayed, Jehan A.;Bakri, Mohamed H.;Mahfouz, Reda Z.
    • The Korean Journal of Pain
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    • v.30 no.2
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    • pp.134-141
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    • 2017
  • Background: Postoperative pain is a common, distressing symptom following arthroscopic knee surgery. The aim of this study was to compare the potential analgesic effect of dexmedetomidine after intrathecal versus intra-articular administration following arthroscopic knee surgery. Methods: Ninety patients undergoing unilateral elective arthroscopic knee surgery were randomly assigned into three groups in a double-blind placebo controlled study. The intrathecal dexmedetomidine group (IT) received an intrathecal block with intrathecal dexmedetomidine, the intra-articular group (IA) received an intrathecal block and intra-articular dexmedetomidine, and the control group received an intrathecal block and intra-articular saline. The primary outcome of our study was postoperative pain as assessed by the visual analogue scale of pain (VAS). Secondary outcomes included the effect of dexmedetomidine on total postoperative analgesic use and time to the first analgesic request, hemodynamics, sedation, postoperative nausea and vomiting, patient satisfaction, and postoperative C-reactive protein (CRP) levels. Results: Dexmedetomidine administration decreased pain scores for 4 h in both the intrathecal and intra-articular groups, compared to only 2 h in the control patient group. Furthermore, there was a significant reduction in pain scores for 6 h in the intra-articular group. The time to the first postoperative analgesia request was longer in the intra-articular group compared to the intrathecal and control groups. The total meperidine requirement was significantly lower in the intra-articular and intrathecal groups than in the control group. Conclusions: Both intrathecal and intra-articular dexmedetomidine enhanced postoperative analgesia after arthroscopic knee surgery. Less total meperidine was required with intra-articular administration to extend postoperative analgesia to 6 h with hemodynamic stability.

Comparative Study on the Effects of Bee Venom Pharmacopuncture According to the Treatment Method for Knee Osteoarthritis

  • Lee, Seung-Hwon;Kwon, Gi-Sun;Kang, Min-Soo;Yoon, Hyun-Min;Kim, Cheol-Hong
    • Journal of Pharmacopuncture
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    • v.15 no.4
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    • pp.7-14
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    • 2012
  • Objectives: The purpose of this study is to compare the effects of bee venom pharmacopuncture (BVP) therapy according to the methods used to treat knee osteoarthritis (OA): intra-acupoint combined with intra-articular injection, intra-acupoint injection, and intra-articular injection. Methods: A total of 69 patients were recruited by the Department of Acupuncture & Moxibustion at Dong-Eui Oriental University Hospital from February 1 to July 23, 2012. The patients were assigned to 3 groups: the first group with intra-acupoint combined with intra-articular BVP Injection (the experimental group), the 2nd group with intra-acupoint BVP injection (control group II), and the 3rd group with intra-articular BVP injection (control group II). The participants were assigned in the order in which they were recruited. Treatments were done twice a week, for a total of 9 times. The effectiveness was assessed by using the visual analouge scale (VAS) and the Korea Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC). Results: All three groups exhibited significant VAS and KWOMAC effects. Moreover, the 4 week follow-up after the final treatment showed a persistence of BVP effects. However, when the groups were compared, no statistically significant differences in VAS and KWOMAC were noted, but when improvement was considered, the results showed that intra-articular injection was more effective than intra-acupoint injection. Especially, intra-acupoint combined with intra-articular injection was the most effective among the three treatments. Conclusions: Combining intra-acupoint with intra-articular injection, depending on the patient's symptoms, may produce better results when conservatively treating knee OA.

The Effect of Intra-articular Bee Venom Injection on Meniscal Injury : Four Cases Report (반월상 연골 손상에 대한 관절강내 봉약침 치료 증례보고 4례)

  • Kim, Dong-Eun;Yu, Deok-Seon;Yeom, Seung-Ryong;Kwon, Young-Dal;Song, Yung-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.1
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    • pp.219-230
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    • 2010
  • According to previous reports, intra-articular bee venom injection is very effective for synovitis, intra-articular lesions. In this article, we report 4 cases of well-treated meniscal tear with intra-articular bee venom injection. We used intra-articular bee venom injection on meniscal tear diagnosed by MR imaging and prescribed herbal medication, physiotherapy if necessary. Outcomes were measured by Visual Analogue Scale(VAS) and Lysholm Knee Scoring Scale. Patients who are treated by intra-articular bee venom injection had a significant effect on the pain reduction, improved range of motion and knee function. Further well-designed, controlled studies and more cases are needed to define the effect of intra-articular bee venom injection on knee.

Intra-articular Lesions and Clinical Outcomes in Traumatic Anterior Shoulder Dislocation Associated with Greater Tuberosity Fracture of the Humerus

  • Lim, Kuk Pil;Lee, In Seung;Kim, In-Bo
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.195-200
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    • 2017
  • Background: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus. Methods: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24-105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up. Results: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up. Conclusions: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

A Case Report of Intra-articular Bee Venom Pharmacopuncture for Adhesive Capsulitis (견관절 유착성 관절낭염에 대한 관절강 내 봉약침 적용 1례)

  • Kwon, O-Gon;Lee, Yun-Kyu
    • Journal of Acupuncture Research
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    • v.29 no.4
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    • pp.99-103
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    • 2012
  • Objectives : This study was performed to report a case of adhesive capsulitis treated by intra-articular bee venom pharmacopuncture. Methods : Patient was treated by intra-articular bee venom pharmacopuncture four times during two weeks, and after that the patient had intermission period for 2 weeks. The same treatment was administered four times during two weeks after the intermission. The effect of treatment was evaluated by visual analog scale(VAS), range of motion(ROM). Results : After treatment, VAS score declined from 7 to 4, ROM increased. Conclusions : Intra-articular bee venom pharmacopuncture was effective for adhesive capsulitis.

Analgesia Effect of Intraarticular Morphine or Ketorolac after Arthroscopic Knee Surgery (관절경을 이용한 슬관절 수술후 관절강내로 투여한 Morphine과 Ketorolac의 진통효과)

  • Kim, Dong-Hee;Park, Mi-Sung
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.28-33
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    • 1997
  • Background : Analgesic effect of intra-articular morphine or ketoronac treatment alone, or a combination of both drugs, on postoperative pain were evaluated in 40 healthy male patients undergoing arthroscopic knee surgery. Method : Upon completion of surgery under spinal anesthesia, each patients knee joint was injected with 30 ml of 0.25% bupivacaine. Then, via parenteral or intra-articular route, one study group received morphine and other group received ketorolac. Results : Groups who received either intra-articular ketorolac, or morphine, experienced decreased postoperative pain reducing need for additional analgesics. The combination treatment of intra-articular morphine and ketorolac did not improved results. Conclusions : Singular use of either intra-articular morphine, or ketorolac, improves postoperative analgesia in patients undergoing arthroscopic sugery: Combination of these drugs offered no further advantage over its single prescription.

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A Case Report of Intra-articular Bee Venom Pharmacopuncture for Partial Tear of Triangular Fibrocartilage Complex. (삼각 섬유연골 복합체 부분 파열에 대한 관절강내 봉약침 시술 치험 1례)

  • Lee, Kwang-Ho;Ryu, Young-Jin;Sun, Seung-Ho;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.12 no.4
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    • pp.127-134
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    • 2009
  • Objective: This case was to report a case of Partial Tear of Triangular Fibrocartilage Complex treated by Intra-articular bee venom Pharmacopuncture. Methods: The patient was treated by Intra-articular bee venom Pharmacopuncture. The Effect of Treatment was evaluated by Visual Analog Scale(VAS) and Modified Mayo Wrist Score(Wrist Score). Results & Conclusions: After Treatment, Patient's VAS decreased and Wrist Score increased. For this results, Intra-articular Bee Venom Pharmacopuncture may be effective for Partial Tear of Triangular Fibrocartilage Complex.

Arthroscopic Excision of Delayed Diagnosed Intra-articular Osteoid Osteoma of the Elbow: A Case Report

  • Park, Sam Guk;Shin, Duk Seop;Choi, Joon Hyuk;Na, Ho Dong;Park, Jae Woo
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.162-168
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    • 2018
  • An intra-articular osteoid osteoma is a very rare cause of elbow pain, and its diagnosis and treatment remain challenging. Delayed diagnosis may lead to arthritic change of the joint. In this study, the authors present the occurrence of intra-articular osteoid osteoma in the right elbow of a 15-year-old male patient who presented with prolonged pain and limited motion owing to delayed diagnosis. After confirming the nidus of osteoid osteoma from radiographic evaluation, the lesion was completely removed arthroscopically. The patient presented a complete relief of symptoms and full range of motion. This is the first domestic report of successful arthroscopic treatment of an intra-articular osteoid osteoma of the elbow.

Effect of Intra-articular Bee Venom Injection on Acute Traumatic Arthritis of Elbow Joint : Two Cases Report (급성 외상성 주관절염에 대한 관절강내 봉약침 치험 2례)

  • Heo, Dong-Seok;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.1
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    • pp.171-180
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    • 2005
  • Objectives : We got a good effect in two patients not by subcutaneous but by subcutaneous but by intra-articular bee venom injection treatments at traumatic arthritis of elbow joint, so report it. Methods : We used only intra-articular bee venom injection treatments at acute traumatic arthritis of elbow joint. After measured the VAS(visual analogue) and ROM(range of motion) of elbow joint, we bee venom injection effect. Results and Conclusions : The symptoms(swelling, pain) and the functions of elbow joint were quickly improved through intra-articular bee venom injection treatments. One case was improved that Rt. elbow joint flexion was increased from $60^{\circ}$ to $150^{\circ}$, extension was increased from $20^{\circ}$ to $0^{\circ}$. The other case was improved that Lt. elbow joint flexion was increased from $90^{\circ}$ to $150^{\circ}$, extension was increased from $30^{\circ}$ to $0^{\circ}$, and both were decreased in VAS. The results suggest that bee venom intra-articular injection has acute pain reduction, anti-inflammation effect.