COMPARISON BETWEEN ROPIVACAINE 1,5 MG ML-1PLUS FENTANYL 2 ΜG ML -1 AND ROPIVACAINE 1,5 MG ML-1PLUS CLONIDINE 1 ΜG ML -1 AS ANALGESIC SOLUTION AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A RANDOMIZED CLINICAL TRIAL

Backround: Ropivacaine is commonly used as local anesthetic for postoperative analgesia through an epidural catheter. Data show that several adjuvants influence the analgesic effect of local anesthetic potency. Objective: The aim of the study was to compare fentanyl and clonidine as adjuvants to 1,5 mg ml-1 ropivacaine in terms of motor blockade, pain relief and side effects. Methods: In this single center, randomized, clinical trial, 52 patient scheduled for arthroscopic anterior cruciate ligament reconstruction were radomly allocated in two groups. At twenty-six patient a solution with ropivacaine 1,5 mg ml-1 plus fentanyl 2 μg ml-1 (group F) was administered through patient controlled epidural analgesia (PCEA) as postoperative analgesia and ropivacaine 1,5 mg ml-1 plus clonidine 1 μg ml-1 (group C) was administered at the remaining twenty-six patients. The VAS score, the Bromage scale and total solution consumption were documented and compared between the two groups for 24 hours after the end of the operation. Results: The mean patient control consumption of the solution was higher at group C respect group F (p = 0,007). At the 8th hour after the operation we register a statistical significant difference at the mean VAS score between the two groups (p 0, 05) with clonidine group achieving a higher score. At the 8th and 12th hour clonidine group register a lower Bromage score than fentanyl group (p 0,005 and p = 0,002). Conclusion: Ropivacaine 1,5 mg ml-1 plus fentanyl 2 μg ml-1 administred through PCEA compared with ropivacaine 1,5 mg ml-1 plus clonidine 1 μg ml-1 h guarantee higher quality analgesia after ACL reconstruction.