Comparison of effect of intraarticularly delivered levobupivacaine and levobupivacaine plus ketamine on postoperative analgesia following arthroscopic knee surgery

Comparison of Effect of Intraarticularly Delivered Levobupivacaine and Levobupivacaine plus Ketamine on Postoperative Analgesia Following Arthroscopic Knee SurgeryObjective: We aim at comparison of effect of intraarticularly delivered levobupivacaine who is a local anesthetic agent and levobupivacaine plus ketamine on postoperative analgesia following arthroscopic knee surgeryMethods: After approval by the ethic committee and a writen informed consent were taken from the patients, 50 patients undergoing arthroscopic knee surgery included in the study. Patients were randomized into two groups following standart general anesthesia induction and maintenance. Patient in group I received 50 mg levobupivacaine, group II received 50 mg levobupivacaine+0,7 mg/kg ketamine via intra-articular route 10 minutes before tourniquet deflation. Hemodynamic parameters were monitorized peroperatively.VAS scores were recorded at 5th, 15th, 30th, 60th and 120th minutes, 4th, 5th, 6th, 12th hours and on 1st and 3rd postoperative days. Additional analgesic was administered to patients whom VAS was ?5.Times of administration of additional analgesic and side effects were also recorded. The patients were also evaluated regarding hemodynamic parameters and sedation postoperatively.Results: No difference was found regarding demographic data (p>0,05). There were difference statistically between groups in hemodynamic data (p<0,05). Hemodynamic parameters of group II was lower than other. There were found difference statistically at 5th, 6th, 12th hours and on1st, 3rd days in VAS scores between groups (p=0,048, p=0,012, p=0,002, p=0,010, p=0,039 ). VAS scores were found lower than other in group II. The groups were also statistically similar regarding additional analgesia requirements and sedation levels (p>0,05).Conclusions: We concluded that administration of sole levobupivacaine and levobupivacaine plus ketamine intraarticularly during arthroscopic knee surgery provided effective postoperative analgesia, however, VAS scores were found lower than other in group II and at 5th hours and subsequent VAS scores were found difference statistically between two groups; thus it would be beneficial for postoperative analgesia that suplementing ketamine to levobupivacaine.Key words: Intraarticular injection, Ketamine, Levobupivacaine, Postoperative pain