title: Efficacy of intraarticular application of ketamine or ketamine-levobupivacaine combination on post-operative pain after arthroscopic meniscectomy.
abstract: To evaluate the efficacy of intraarticular injection of ketamine or ketamine plus levobupivacaine on post-operative analgesia in patients undergoing arthroscopic meniscectomy.
  
  
  
  A prospective, randomized, double-blind study was performed on 60 patients aged 18-65 years who planned to undergo elective arthroscopic meniscectomy. The patients were divided into three groups: the ketamine group (n = 20) received 1.0 mg/kg of intraarticular ketamine in 20 ml of normal saline, the ketamine-levobupivacaine group (n = 20) received 0.5 mg/kg of intraarticular ketamine plus 50.0 mg of 0.25 % levobupivacaine in 20 ml of normal saline, and the control group (n = 20) received 20 ml of intraarticular normal saline. A visual analogue scale (VAS) was used to determine the efficacy of analgesia at 1, 2, 4, 6, 8, 12, and 24 h post-operatively.
  
  
  
  There were statistically significant differences in the median VAS scores among the three groups according to Bonferroni adjustment at all time points (p < 0.01), with the exception of 6 and 24 h post-operatively. The median VAS scores at 1, 2, and 4 h post-operatively were higher in the control group than in the two treatment groups (p < 0.001). The median VAS scores in the control group at 1, 2, 4, 6, 8, and 12 h post-operatively and those in the ketamine group at 4, 8, and 12 h post-operatively were significantly higher than those in the ketamine-levobupivacaine group (p < 0.05).
  
  
  
  Intraarticular ketamine provides effective post-operative analgesia. Addition of intraarticular levobupivacaine to ketamine may provide better amelioration of pain after outpatient arthroscopic meniscectomy.
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine, Abant İzzet Baysal University Medical School, Abant İzzet Baysal University, 14280, Gölköy, Bolu, Turkey, drcengiz034@yahoo.com.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Isik
authors.forename: Abdullah
authors.initials: A
authors.lastname: Demirhan
authors.forename: Tevfik
authors.initials: T
authors.lastname: Yetis
authors.forename: Korgun
authors.initials: K
authors.lastname: Okmen
authors.forename: Hakan
authors.initials: H
authors.lastname: Sarman
authors.forename: Umit Yasar
authors.initials: UY
authors.lastname: Tekelioglu
authors.forename: Turan
authors.initials: T
authors.lastname: Duran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007649:Ketamine / Q000008:administration & dosage*; D007719:Knee Joint / Q000601:surgery*; D000077554:Levobupivacaine; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D007649:Ketamine; D000077554:Levobupivacaine; D002045:Bupivacaine