PURPOSE: this study was conducted to identify the most effective method of postoperative pain management, comparing the intravenous opiate infusion protocol with the use of a single periarticular local anesthetic infiltration (LAI) in patients undergoing total knee arthroplasty (TKA) surgery. METHODS:50 patients submitted to TKA surgery between 2013 and 2015 were divided into two groups. Buprenorphine was administered intravenously to the patients in Group A, while the Group B patients received a single periarticular LAI (ropivacaine and ketorolac) during surgery. Pain was assessed using a visual analog scale (VAS) and the knee injury and osteoarthritis outcome score. Hemoglobin and hematocrit were measured in the early postoperative period and at 40 days post-surgery. Range of motion and inflammatory markers were also assessed. Statistical analysis was performed using Student's t-test. RESULTS: student's t-test showed no significant difference between the groups in functional outcomes or blood values, but a difference in VAS score on the day of surgery was found (p < 0.0001), in favor of Group B. CONCLUSIONS: LAI considerably reduces postoperative pain, allowing rapid mobilization and accelerating functional recovery. LEVEL OF EVIDENCE: Level I, prospective single-blind randomized trial.
RCT Entities:
PURPOSE: this study was conducted to identify the most effective method of postoperative pain management, comparing the intravenous opiate infusion protocol with the use of a single periarticular local anesthetic infiltration (LAI) in patients undergoing total knee arthroplasty (TKA) surgery. METHODS: 50 patients submitted to TKA surgery between 2013 and 2015 were divided into two groups. Buprenorphine was administered intravenously to the patients in Group A, while the Group B patients received a single periarticular LAI (ropivacaine and ketorolac) during surgery. Pain was assessed using a visual analog scale (VAS) and the knee injury and osteoarthritis outcome score. Hemoglobin and hematocrit were measured in the early postoperative period and at 40 days post-surgery. Range of motion and inflammatory markers were also assessed. Statistical analysis was performed using Student's t-test. RESULTS: student's t-test showed no significant difference between the groups in functional outcomes or blood values, but a difference in VAS score on the day of surgery was found (p < 0.0001), in favor of Group B. CONCLUSIONS: LAI considerably reduces postoperative pain, allowing rapid mobilization and accelerating functional recovery. LEVEL OF EVIDENCE: Level I, prospective single-blind randomized trial.
Entities:
Keywords:
arthroplasty; knee; local anesthetic infiltration; opiate; pain management
Authors: Nitin Goyal; James McKenzie; Peter F Sharkey; Javad Parvizi; William J Hozack; Matthew S Austin Journal: Clin Orthop Relat Res Date: 2013-01 Impact factor: 4.176
Authors: M Ratajczak-Enselme; J-P Estebe; F-X Rose; E Wodey; J-M Malinovsky; F Chevanne; G Dollo; C Ecoffey; P Le Corre Journal: Br J Anaesth Date: 2007-10-23 Impact factor: 9.166