Analgesic Efficacy of Levobupivacaine Injected Intraarticularly Following Knee Arthroscopy

Abstract

Background: One of the most popular surgeries is arthroscopic knee surgery. The majority of the knee's intraarticular structures include free nerve endings that may detect painful stimuli and cause excruciating pain. For the rehabilitation of the knee after surgery, effective pain treatment is crucial. Levobupivacaine is an example of an intraarticular local anaesthetic that may be used to treat pain because it produces a direct blocking of the nociceptive pain response at the site of injection with very little systemic absorption. Objective: To evaluate the analgesic efficacy of levobupivacaine injected intraarticularly following knee arthroscopy. Patient and method: Eighty patients (ASA I or II) of either sex, aged from 18-70 years undergoing elective arthroscopic knee surgery were randomly categorized into two groups 40 patients for each. Group C received 20 ml normal saline 0.9%. Group L received levobupivacaine 0.5% (Chirocaine® 5mg/ml from Abbott) intraarticularly at the end of the surgery and 10 min before tourniquet deflation. Patients were monitored postoperatively by using (VAS) score, (HR) and (MBP) at 1, 6, 12, 18, 24 hours. Results: We found that intraarticular levobupivacaine injection after knee arthroscopy provides postoperative analgesia without causing hemodynamic instability with less postoperative supplemental analgesic requirements. Postoperative VAS score was statistically significant lower in group L when compared to group C. The time of the first request for analgesia was longer in group L than group C. However, there was no serious side effects detected in either groups. Conclusion: Intraarticular levobupivacaine injection after knee arthroscopy provides efficient postoperative analgesia, less postoperative supplemental analgesic requirements with hemodynamic stability and insignificant complications.