Postarthroscopy analgesia using intraarticular levobupivacaine and intravenous dexketoprofen trometamol

Knee Surg Sports Traumatol Arthrosc. 2015 Dec;23(12):3516-22. doi: 10.1007/s00167-014-3191-2. Epub 2014 Jul 22.

Abstract

Purpose: The aim of this prospective study was to determine the efficacy of intraarticular levobupivacaine with and without intravenous dexketoprofen trometamol for postarthroscopy analgesia.

Methods: Sixty patients who underwent arthroscopic knee surgery were randomly assigned to three treatment groups. When the surgical procedure was completed, patients received the following treatments: group I (n = 20) patients received 20 mL intraarticular normal saline and 2 mL intravenous dexketoprofen trometamol (50 mg); group II (n = 20) patients received 20 mL intraarticular 0.5 % levobupivacaine (100 mg) and 2 mL intravenous normal saline; and group III (n = 20) patients received 20 mL intraarticular 0.5 % levobupivacaine (100 mg) and 2 mL intravenous dexketoprofen trometamol (50 mg). The visual analogue scale (VAS) was used, and the total analgesic consumption was assessed at 1, 2, 4, 6, 12, and 24 h post-operatively.

Results: The VAS scores at 1, 2, 4, 6, 12, and 24 h post-operatively were significantly increased in group I and group II compared with group III (p < 0.05). The average VAS score during the first 24 h post-operatively was significantly lower in group III than in group I and group II (p < 0.001). Total meperidine consumption was significantly lower in group III than in groups I and II (p < 0.001).

Conclusion: Intraarticular levobupivacaine with adjuvant intravenous dexketoprofen trometamol administration provided better pain relief and less analgesic requirement after arthroscopic knee surgery during the first 24 h than that induced by dexketoprofen alone or levobupivacaine intraarticular alone.

Level of evidence: II.

Keywords: Arthroscopy; Dexketoprofen trometamol; Levobupivacaine; Post-operative analgesia; Post-operative pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesia / methods
  • Analgesics / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Arthroscopy / adverse effects*
  • Bupivacaine / administration & dosage
  • Bupivacaine / analogs & derivatives*
  • Double-Blind Method
  • Female
  • Humans
  • Infusions, Intravenous
  • Injections, Intra-Articular
  • Ketoprofen / administration & dosage
  • Ketoprofen / analogs & derivatives*
  • Levobupivacaine
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Tromethamine / administration & dosage*
  • Visual Analog Scale

Substances

  • Analgesics
  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Tromethamine
  • Ketoprofen
  • Levobupivacaine
  • dexketoprofen trometamol
  • Bupivacaine