Diz cerrahisinde morfin ve epinefrin ile uygulanan intraartiküler bupivakain ve levobupivakainin karşılaştırılması

Comparison of intraarticular bupivacaine and levobupivacaine with morphine and epinephrine for knee arthroscopy

Alp GURBET, Burak DEMİRAG, Nurdan OZDEMİR, Bilgen MANDIRACI ONBASI, Aysun YILMAZLAR, Fatma Nur KAYA

Abstract

Objective: To compare the efficacy of intraarticularly injected bupiv-acaine with levobupivacaine when administered in combination withmorphine and adrenaline for post-operative analgesia and functionalrecovery after knee surgery.Materials and Methods: Sixty American Society of Anesthesiologists physical status I–II patients were randomized into three groups: Group B was administered 30 mL isobaric 0.5% bupivacaine, 2 mg morphine and 100 μg adrenaline, Group L was administered 30 mL 0.5% levobupivacaine, 2 mg morphine and 100 μg adrenaline, and Group C was administered 30 mL 0.9% NaCl solution into the knee joint by the surgeon at the end of surgery. The morphine usage and visual analog pain scores were recorded regularly afterwards. We also recorded the time that elapsed before each patients’ first mobilization, positive response to straight leg raising, tolerance to 30-50° knee flexion, recovery of quadriceps reflexes and discharge from the hospital. We also recorded patient and surgeon satisfaction. Results: The pain scale values were lower in Groups B and L than in Group C at 2, 4, 6, 8, 12 and 24 hours post-operatively (all p

Özet

Amaç: Morfin ve epinefrin eklenerek intraartiküler uygulanan bupi- vakain ve levobupivakainin postoperatif ağrı ve fonksiyonel iyilşeme üzerine etkisini incelemek. Gereç ve Yöntem: ASA I-II 60 hasta randomize edilerek 3 gruba ayrıldılar: Grup B; 30 mL izobarik %0.5 bupivakain+2 mg morfin+100 mg adrenalin, Grup L; 30 mL %0.5 levobupivakain+2 mg morfin+100 mg adrenalin, Grup K; 30 mL serum fizyolojik cerrahi ekip tarafından operasyon bitiminde intraartiküler olarak uygulandı. Postoperatif morfin tüketimi, ağrı skorları, ilk mobilizasyon zamanları, 30-50 derece diz fleksiyonuna tolerans zamanları kaydedildi. Bulgular: Ağrı skorları Grup B ve L’de Grup K’ya göre 2, 4, 6, 8, 12 ve 24 satlerde daha düşük bulundu (p