A prospective randomised double blind study comparing the efficacy of peri-articular injection with bupivacaine and levobupivacaine for postoperative pain control in total knee arthroplasty
Abstract
Objective: Adequate control of postoperative pain management after total knee arthroplasty (TKA) remains a big challenge for the clinicians, as if left unrelieved, it might cause a delayed recovery of the patient and a prolonged hospital stay. Not much literature is found regarding the peri-articular use of levobupivacaine in patients undergoing TKA. So, we aimed to compare the efficacy of peri-articular infiltration of bupivacaine and levobupivacaine for postoperative pain control in TKA.
Methodology: We organised a randomised, prospective, double blind study and enrolled sixty patients undergoing TKA by a single surgeon. Group L (Levobupivacaine) received peri-articular injections with 0.20% levobupivacaine before wound closure and Group B (Bupivacaine) patients received a 0.25% bupivacaine injection. All the cases were performed by a standardized anesthetic technique, postoperative pain control and rehabilitation protocol.
Results: Postoperative morphine consumption within first twelve hours was observed to be significantly reduced in Group L (P < 0.05). However, no significant difference was observed in the two groups on comparing postoperative morphine consumption between 12-96 hours. VAS scores were also found to be comparable between the groups.
Conclusion: Administration of peri-articular injection with levobupivacaine before the wound closure was shown to be an effective method for postoperative analgesia after TKA with minimal side effects.
Key words: Bupivacaine; Levobupivacaine; Peri-articular injection; Total knee arthroplasty
Citation: Varshney RK, Huda N. A prospective randomised double blind study comparing the efficacy of peri-articular injection with bupivacaine and levobupivacaine for postoperative pain control in total knee arthroplasty. Anaesth Pain & Intensive Care 2016;20(3):315-319
Received: 25 June 2016; Reviewed: 30 August & 12 September 2016; Accepted: 14 September 2016