Comparison of efficacy of intraarticular application of magnesium, levobupivacaine and lornoxicam with placebo in arthroscopic surgery

Abstract

Arthroscopic knee surgery is done in outpatient settings; however, postoperative pain is a major barrier for discharge and limits early rehabilitation. The efficacy of intraarticular application of magnesium sulphate, levobupivacaine and lornoxicam, with placebo on postoperative pain after arthroscopic meniscectomy was evaluated. One hundred and twenty ASA status I-II patients undergoing elective arthroscopic meniscectomy were included in this randomized, single blind, prospective study. Group-M (GM) patients had intraarticular 500 mg of magnesium sulphate in 20 ml saline; group-P (GP) patients had intraarticular 20 ml saline; group-LB (GLB) patients had 100 mg levobupivacaine in 20 ml (0.5%); group-L (GL) patients had intraarticular 8 mg of lornoxicam in 20 ml saline before tourniquet deflation. Postoperative analgesia was maintained by iv tramadol PCA 0.3 mg kg(-1) bolus dose and 5 min lockout time during the first 4 h and later with paracetamol 500 mg. The NRS values at rest and at exercise and analgesic consumptions were evaluated at the end of the first, second and 4th hours and at the 12th, 24th and 48th hours by an anaesthesiologist who was blind to the solutions administered. All study groups provided analgesia when compared with GP. The first request of oral analgesic time was shorter in GP. Analgesic consumptions of GP were higher than other groups. Pain scores during 1, 2 and 4 h postoperatively were lower in all study groups than the GP. Administration of all the drugs provided better analgesia than placebo and the most effective one was lornoxicam.