Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effects of different doses of ropivacaine on postoperative analgesia, incidence of complications and stress factors in patients undergoing total knee arthroplasty

Xiaobo Sun^1,2 , Yuting Liu³, Jian Li⁴, Haihua Liu⁵

¹The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12, District Baiyun, Guangzhou, Guangdong, China; ²Orthopedics and Traumatology, Ganzhou Hospital of Traditional Chinese Medicine, Xijin Road 16, District Zhanggong, China; ³Academic Affairs Office, Gannan Medical University, Ganzhou, Jiangxi, China; ⁴Department of Ultrasound, Boai Hospital of Zhongshan, Zhongshan, Guangdong, China; ⁵First Affiliated Hospital of Gannan Medical University, Qingnian Road 23, District Zhanggong, Ganzhou, Jiangxi, China.

For correspondence:- Xiaobo Sun Email: sp5is2@163.com

Accepted: 26 August 2022 Published: 30 September 2022

Citation: Sun X, Liu Y, Li J, Liu H. Effects of different doses of ropivacaine on postoperative analgesia, incidence of complications and stress factors in patients undergoing total knee arthroplasty. Trop J Pharm Res 2022; 21(9):1979-1984 doi: 10.4314/tjpr.v21i9.23

© 2022 The authors.
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Abstract

Purpose: To study the influence of various doses of ropivacaine (Ropi) on postoperative analgesia, incidence of complications and stress factors in patients undergoing total knee arthroplasty (TKA).

Methods: One hundred and fifty (150) patients who received TKA treatment in Ganzhou Hospital of Traditional Chinese Medicine from January 2017 to January 2019 were randomly assigned to low-dose Ropi (0.15 %, group A), medium-dose Ropi (0.20 %, group B) and high-dose Ropi (0.30 %, group C), with 50 patients in each group. Changes in visual analogue scale (VAS) scores, MMSE scores, cognitive dysfunction, serum cortisol (Cor) and adverse reactions were determined before and after surgery.

Results: Compared with group A, scores on rest visual analogue scale (RVAS) and passive visual analogue scale (PVAS) were significantly higher in low-dose and high-dose Ropi groups 24 and 48 h postoperatively (p < 0.05). Serum Cor levels in low-dose Ropi-treated patients were significantly lower than those in the other groups at 24 and 48 h after surgery (p < 0.05). The MMSE scores at 48 and 72 h after surgery were significantly higher in low-dose Ropi-treated patients than in the other 2 groups. The number of patients with cognitive impairment after surgery (POCD) was significantly higher in groups B and C than in A (p < 0.05).

Conclusion: Low-dose Ropi exerts significant analgesic effect on elderly patients undergoing TKA, and improves their cognitive function without increasing stress response. Therefore, it should be further investigated on a larger scale for its potential as a candidate analgesic for patients after TKA.

Keywords: Ropivacaine, Total knee arthroplasty, Postoperative analgesia, Stress factors