Comparison of effect of intraarticularly delivered levobupivacaine morphine and tramadol combinations on postoperative analgesia following arthroscopic knee surgery

ABSTRACTComparison of Effect of Intraarticularly Delivered Levobupivacaine Morphineand Tramadol Combinations on Postoperative Analgesia Following ArthroscopicKnee Surgery.After approval by the ethic committee and a written informed consent weretaken from the patients, 66 patients undergoing arthroscopic knee surgery included inthe study. Patients were randomized into three groups following standard generalanesthesia induction and maintenance. Patients in group L received 100 mglevobupivacaine, group LM received 100 mg levobupivacaine + 10 mg morphine, andgroup LT received 100 mg levobupivacaine + tramadol via IA route 10 minutes beforetourniquet deflation. Hemodynamic parameters were monitorized peroperatively. VASscores were recorded at 5th, 10th, 30th, and 60th minutes, 2nd, 6th, 12th, and 24th hours, andon 3rd and 7th postoperative days. Additional analgesic was administered to patientswhom VAS was ≥5. Times of administration of additional analgesic and side effectswere also recorded. The patients were also evaluated regarding hemodynamicparameters and sedation postoperatively.No difference was found regarding demographic and hemodynamic data (P >0.05). Postoperative analgesia was found to be effective in all of the groups (P > 0.05).There was no difference when comparing postoperative hemodynamic parameters andsedation levels between the groups (P > 0.05). The groups were also statistically similarregarding additional analgesia requirements (P > 0.05). No complication was observedin any of the patients.We concluded that administration of sole levobupivacaine, levobupivacaine plusmorphine, and levobupivacaine plus tramadol intraarticularly during arthroscopic kneesurgery provided effective postoperative analgesia, however, although not significant,patients receiving sole levobupivacaine and levobupivacaine plus tramadol groupsrequire more additonal analgesia, especially in initial 30 minutes; thus supplementingmorphine to levobupivacaine would be beneficial for early postoperative analgesia.Key words: Intraarticular injection, Levobupivacaine, Morphine, Postoperativepain, TramadolVIII