Intra Articular Administration;

Objectives: The aim of our study is to provide a comparison betweenlevobupivacaine and bupivacaine administered intra articulary in the knee joint duringarthroplasty procedures, and compare the postoperative analgesic effects. Method: StudyDesign: Randomized control trial. Period: One year duration from March 2015 to March 2016.Setting: Tertiary care centre in Karachi, Pakistan. The study population consisted of n= 50patients belonging to ASA class II and III, who were scheduled to undergo TKA (total kneearthroplasty). The patient population was divided into two groups, group A consisted of all thepatients who received bupivacaine, and group B consisted of all the patients who receivedlevobupivacaine. All the patients were between the ages of 18 and 70 years, and had normaljoint mobility. After explaining the procedure and taking due informed consent, the patientswere informed about the use of the visual analog scale for pain and the patients controlledepidural anesthesia (PCEA). Readings of echocardiograph, blood pressure and pulse oximetry,sensory and motor characteristics of the established block, side effects, number of bolusesand doses of PCEA, total amount of pain relief medications utilized over the period, VAS scoresand time of mobilization and discharge from the hospital were also noted in a pre-designed.Statistical analysis was done using SPSS version 23. Results: The study population consistedof n= 50 patients. The VAS scores at were found to be lower in the bupivacaine group at 4,8,12and 24 hours and VAS scores at 48 hour were lower in levobupivacaine group having a p valueof less than 0.05, but the VAS scores were similar at the 0,2 and 72 hours in both the groups.The post-operative analgesic requirement was similar for both groups. The sensation of painat the time of post-operative physiotherapy measure with the VAS score, was also similar inthe two groups having a p value of less than 0.05. Similar results were found between the timeof discharge and time of mobility, having a p value of less than 0.05. Conclusion: The use ofmultimodal analgesia with the administration of intra articular local anesthetics combined withPCEA is a very effective method to provide post-operative pain relief in patients undergoing totalknee arthroplasty.