Efficacy and Safety of Lidocaine Patch 5% Supplementation to Intra-articular Bupivacaine Dexmedetomidine after Knee Arthroscopy under General Anesthesia: A Randomized Controlled Study

Abstract

ABSTRACT Background: Adequate pain management after knee arthroscopy (KA) under general anesthesia (GA) is often problematic. Therefore, we evaluated the efficacy and safety of lidocaine patch 5% (LP5) supplementation to intra-articular (IA) bupivacaine and dexmedetomidine after KA under GA.Methods: This randomized controlled study was conducted on 40 adult patients undergoing KA under GA. Patients were randomized into two groups (20 patients in each). At the end of the surgery, group A received an IA injection of 10 ml bupivacaine 0.5% and 1 µg/kg dexmedetomidine diluted in 10 ml saline. Group B received as group A, and one LP5 (700 mg) applied at the portal site for 12 h postoperatively. Intravenous pethidine 20 mg was administered if the postoperative visual analogue scale (VAS) was ≥4.Results: The postoperative pethidine consumption in the first 24 h was significantly lower in group B. The time of the first request of analgesia and number of patients discharged at 24 h were significantly higher in group B. Heart rate, mean arterial pressure, and VAS were significantly higher in group A at 6, 8, and 12 h postoperatively. In group B, serum lidocaine levels reached its peak (31.4 ± 3.01 ng/mL) at 12 h and were negatively and strongly correlated with VAS at 12, 18, and 24 hours (r = −0.736 and P < 0.001). All postoperative adverse effects were minimal and mild.Conclusion: After KA, LP5 supplementation to IA bupivacaine and dexmedetomidine decreased the postoperative pain and narcotic requirements safely.