Comparison of Patient Controlled Intravenous Analgesia and Patient Controlled Regional Analgesia through Femoral Catheter after Anterior Cruciate Ligamentum Repair

Post operative pain is one of the most common complains in surgery wards especially in orthopedics surgery. Analgesic methods vary and include intravenous, regional (by peripheral nerve block) and epidural. In this study, we evaluated two methods of Patient Controlled Anesthesia (PCA) i.e.intravenously (Patient Controlled Intravenous Analgesia-PCIA) with Morphine 0.2% and regional by peripheral femoral nerve block (Patient Controlled Regional Analgesia-PCRA) with Bupivacaine 0.1%, to reduce post-operative pain after Anterior Cruciate Ligamentum (ACL) repair. The study was a randomized clinical trial. Seventy patients candidates of ACL repair surgery were re-enrolled and assigned in two PCIA and PCRA groups, randomly. In PCIA group the patients received Morphine 0.2% and in PCRA group, after femoral nerve block in recovery and insertion of the catheter, the PCRA pump was filled with Bupivacaine 0.1%. Visual analogue scale for pain severity was measured and recorded 1, 8, 16, 24, 32 and 40 hours post-operatively. Statistical analysis was performed by Chi square, t-test, and analysis of variance. SPSS V.13 was used for data analysis. Demographic data was the same in both groups. Although the pain score was less than 3 during all follow-ups in both groups, pain score in PCRA in the first hour postoperative time was less than that in the PCIA. However, the pain severity at other times (8, 16, 24, 32, 40 hours after the surgery) in PCIA group was significantly less than that in PCRA group. No side effects were observed in the patients. Our finding showed that postoperative pain was favorably reduced in both PCIA and PCRA groups after ACL repair; however pain relief was better in PCIA than PCRA group.