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MINERVA ORTOPEDICA E TRAUMATOLOGICA
Rivista di Ortopedia e Traumatologia
Minerva Ortopedica e Traumatologica 2014 June;65(3):231-6
Comparison of efficacy of intraarticular injection of levobupivacain versus levobupivacain and prilocaine following arthroscopy of the knee
Erdoğan M. 1, Desteli E. E. 2, İmren Y. 2, Kiliç M. 1, Sezgin H. 3 ✉
1 Department of Orthopaedics and Traumatology, Ondokuz Mayıs University, Samsun, Turkey;
2 Department of Orthopaedics and Traumatology, Üsküdar State Hospital, İstanbul, Turkey;
3 Kaman State Hospital, Kırşehir, Turkey
AIM: The aim of this paper was to compare postoperative analgesic effects of levobupivacaine and levobupivacaine combined with a rapid-onset local analgesic agent (prilocain) after arthroscopy of the knee.
METHODS: Forty patients aged between 20-60 years undergoing elective arthroscopic partial meniscectomy for symptomatic isolated irreparable tears were included. Institutional review board and signed informed consent were obtained. Patients were randomly divided into two groups. Patients in group 1 (N.=20) received 20 mL levobupivacaine and in group 2 (N.=20) patients received mixture of 10 mL levobupivacaine + 10 mL prilocain intra-articularly. Demographically both of the groups were similar in means of age, gender and mean tourniquet time of both groups were also similar. Visual Analogue Scale (VAS) scores were noted both during rest and activity respectively postoperative at 10th, 20th, 30th, 60th minutes and 4th, 8th, 16th and 24th hour. Normality test was performed in order to determine if the data set was well-modeled by a normal distribution, otherwise Mann Whitney U-test was used as a non-parametric test. Statistically P<0.05 was accepted as significant.
RESULTS: None of the patients had intraoperative or postoperative hypotension, hypoxemia, bradycardia, any reactions to drugs or postoperative infection. VAS scores recorded during activity at 20th minute was found to be lower in group 1 (P<0.05), at 24th hour it was found to be lower in group 2 (p<0.05). Postoperative need for additional analgesic medication was found to be 5 % in Group 1 (1 patient) and 15 % in group 2 (3 patients) (P>0.05).
CONCLUSION: Administration of levobupivacaine showed significantly better VAS scores at the initial hours following the operation. We believe that later studies should be made with combinations of levobupivacaine with other long-acting agents to investigate late postoperative analgesic efficacy.