Postoperative pain management using femoral nevre block with Levobupivacaine and Dexamethasone added Levobupivacaine in patients with total knee prothesis and lower extremity surgery

Objective: The aim of this study is postoperative pain control and to prolong the painless period by nerve stimulator assisted femoral nerve block with 0.5% levobupivacaine and 8 mg dexamethasone.Materials and methods: After getting the oral and written approval of patients and Çukurova University Ethic Council we included 40 orthopaedics patients whom undergo total knee prothesis and lower extremity surgery.The patients randomly divided into two groups; in group 1 we used 0.5% levobupivacaine in 20 ml solution. İn group 2 we added 8 mg (2 ml) dexamethasone to same dose and volume of levobupivacaine. We used a nevre stimulator to performe the nevre block. After the block we measured hemodynamic parameters in 1., 5., 15., 30., 60., 120. Minutes. The first measurements after the block accepted as the control group. After the surgery patients fallowed in orthopaedics clinic and all measurements of 6., 12, and 24. Hours evaluated. After the second and third days of surgery we recorded the side effects and Visual Analogue Scale values. We applied 1 mg/kg intravenous tramadol hydrochloride when pain begins.Results: Demographic measurements was similar. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, hearth rate, oxygen saturation, Vısual Analogue Scale was similar. The Visual Analogue Scale measurements in 60. Minutes was significantly lower in the group which levobupivacaine and dexamethasone was used (p<0.05).Conclusion: For postoperative pain kontrol, single dose femoral nevre block is an effective method after total knee prothesis and lower extremity surgery. Dexamethasone added local anesthetics is more effective in early period but the later effectiveness is not determined.Key Words: Femoral nerve block, levobupivacaine, dexamethasone, Visual Analogue Scale