Intra-articular levobupivacaine, lornoxicam and morphine analgesia after knee arthroscopy: a randomized, controlled trial

Objective: The aim of this study was to compare the analgesic effects of intra-articular levobupivacaine alone, intra-articular levobupivacaine in combination with lornoxicam, and intra-articular levobupivacaine in combination with lornoxicam and morphine on patients following arthroscopic surgery.Methods: The study included 60 ASA 1 and 2 patients between the ages of 20 and 70 years, scheduled for elective arthroscopy. Patients were divided into three groups of 20 through a randomized, double-blind method. Group 1 received 50 mg of levobupivacaine intra-articularly, Group 2 received 50 mg of levobupivacaine plus 8 mg of lornoxicam, and Group 3 received 50 mg of levobupivacaine plus 8 mg of lornoxicam and 8 mg of morphine. Visual analog scale (VAS) data was collected prospectively for the first 24 postoperative hours.Results: Group 2 showed statistically significant differences, especially in VAS values with movement at 0, 4, and 6 hours (p 0.001).Conclusion: The combination of levobupivacaine and lornoxicam is superior to levobupivacaine alone and the addition of morphine does not improve VAS scores. It appears that the addition of additional drugs for more effective analgesia has its limits.