Blood levels of bupivacaine after arthroscopy of the knee joint.

Toxic levels of bupivacaine have been reported in other types of surgery, but have not been previously noted in arthroscopic procedures. The purpose of this study was to evaluate bupivacaine levels after an intraarticular bolus of bupivacaine administered after arthroscopic surgery. Blood levels of bupivacaine were found to be significantly higher in patients in whom synovial surgery had been performed compared with those patients in whom the procedure involved only meniscal or articular cartilage surgery. A reduction in the bupivacaine dosage when the synovium has been resected or divided is recommended to keep the serum level below the potentially toxic range.