Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

Abstract

Background: Local anaesthetics in intra-articular route are commonly used for the management of pain after arthroscopic knee surgery. Dexmedetomidine prolongs the duration of commonly used local anesthetics. In this study, analgesic effect of intra-articular administration of levobupivacaine and dexmedetomidine was compared with ropivacaine and dexmedetomidine in arthroscopic knee surgery. Methods: 80 patients, aged between 20 to 60 years of ASA I and II posted for knee arthroscopy were divided into two equal groups (n = 40) in a randomized double blind study. Patients in Group LD received 10 ml of 0.5% levobupivacaine and 1 mcg/kg dexmedetomidine and Group RD received 10 ml of 0.75% ropivacaine and 1 mcg/kg of dexmedetomidine through intra-articular route at the end of the surgery. In the post-operative period, pain intensity was assessed by visual analogue scale(VAS) VAS score was recorded at 1 st , 5 th , 8 th , 12 th and 18 th post-operative hours. Duration of analgesia, total rescue analgesic requirement in first 18 hours and any side effects were recorded. Results: Group LD showed significantly longer duration of postoperative analgesia and lesser rescue analgesic requirement compared to group RD. Group RD had higher mean VAS score at 5 th and 12 th post-operative hours compare to group LD. Conclusion: Intra-articular levobupivacaine and dexmedetomidine combine provides better postoperative pain relief by increasing duration of the analgesia, and decreasing the need of rescue analgesic compared to intra-articular ropivacaine and dexmedetomidine.