Purpose
This prospective, randomized, blinded study was designed to compare the effects of
warmed versus room-temperature levobupivacaine in patients undergoing knee arthroscopy
and partial meniscectomy.
Methods
Patients were randomly allocated into 2 groups of 16 patients each. In all patients
the 2 portal sites were infiltrated with 10 mL of room-temperature mepivacaine (20
mg/mL). In the first group, patients underwent intra-articular injection of 20 mL
of levobupivacaine (5 mg/mL) and 0.005-mg/mL epinephrine (1:200,000) at a temperature
of 40°C ± 0.2°C, whereas in the second group the levobupivacaine and epinephrine were
at room temperature (25°C ± 0.5°C). Pain was graded and recorded intraoperatively
and postoperatively by use of a visual analog scale (VAS). Analgesia was supplemented
if the VAS score was 4 cm or greater with morphine intraoperatively or ketorolac postoperatively.
Results
There were no significant differences between groups in intraoperative and postoperative
VAS values. There was no need for morphine as a rescue dose in any patient during
surgery. Eight patients treated with warmed levobupivacaine and seven patients treated
with room-temperature levobupivacaine requested a single rescue dose of ketorolac
(30 mg) postoperatively.
Conclusions
No compelling evidence exists to suggest that intra-articular injection of warmed
levobupivacaine is more effective than room-temperature levobupivacaine for intraoperative
anesthesia and postoperative analgesia in patients undergoing partial meniscectomy
during knee arthroscopy.
Level of Evidence
Level I, randomized controlled trial.
Key Words
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Article info
Publication history
Accepted:
March 21,
2009
Received:
October 14,
2008
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
