Pain relief in day care arthroscopic knee surgery: a comparison between intra-articular ropivacaine and levobupivacaine: a prospective, doubleblinded, randomized controlled study

ABSTRACT

Post-operative pain frequently hampers implementation of day care arthroscopic knee surgery in spite of so many analgesic, local anesthetic drugs and routes of administration. The aim of the present study was carried out to compare the efficacy of ropivacaine and levobupivacaine when administered through intra-articular route in controlling pain after day care arthroscopic knee surgery. It was a prospective, double-blinded and randomized controlled study. April 2008-December 2008, 60 patients of both sex, of American Society of Anesthesiologists physical status I and II, undergoing day care arthroscopic knee surgery were randomly assigned into two groups [R, L]. Group R received 10 ml of 0.75% ropivacaine, whereas group L received 10 ml of 0.50% levobupivacaine through intra-articular route at the end of the procedure. Pain assessed using visual analog scale [VAS] and diclofenac sodium given as rescue analgesia when VAS >3. Time of first analgesic request and total rescue analgesic were calculated. Based on comparable demographic profiles; time for the requirement of first post-operative rescue analgesia [242.16 +/- 23.86 vs. 366.62 +/- 24.42] min and total mean rescue analgesic requirement was [104.35 +/- 18.96 vs. 76.82 +/- 14.28] mg in group R and L respectively. Group R had higher mean VAS score throughout the study period. No side effects found among the groups. These two results were clinically and statistically significant [P < 0.05]. Hence, it was evident that intra-articular levobupivacaine give better post-operative pain relief, with an increase in time of first analgesic request and decreased need of total post-operative analgesia compared with ropivacaine