• Murat Unal, Nevzat Gumus, Nizamettin Guzel, Serkan Tulgar, Ersin Koksal, and Mustafa Suren.
• Department of Anaesthesiology and Reanimation, Samsun University, Samsun Training and Research Hospital, Samsun, Turkiye.
• J Coll Physicians Surg Pak. 2024 Mar 1; 34 (3): 256261256-261.

ObjectiveTo determine the myotoxicity of bupivacaine on muscles after suprainguinal fascia iliaca block for postoperative analgesia in total knee arthroplasty (TKA) patients through changes in serum creatine phosphokinase (CPK) levels during the perioperative period.Study DesignObservational study. Place and Duration of the Study: Postoperative Recovery Room department of Anaesthesiology and Reanimation, Samsun University, Samsun, Training and Research Hospital, Samsun, Turkiye, between December 2022 and February 2023.MethodologyPatients undergoing for the procedure of TKA surgery were recruited. (40 controls and 42 SIFIB groups). Serum CPK levels were evaluated preoperatively, at postoperative 6th hour and 24th hour.Results From total 82 patients, 42 of them who received SIFIB as a component of multimodal analgesia had serum CPK levels comparable to those in the control group at all time points (p>0.05). While the increase in CPK level at 6th hour relative to baseline was significant in both groups (p<0.05), only the block group demonstrated a statistically significant difference between the 6th and 24th hours (p<0.05).ConclusionSIFIB administration did not result in severe bupivacaine-induced myotoxicity in comparison to the control group. SIFIB administration is a safe option when used as part of multimodal analgesia in TKA.Key Words Bupivacaine, Creatine phosphokinase, Myotoxicity, Regional anaesthesia.

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