Local infiltration analgesia with additional intraarticular catheter provide better pain relief compared to single-shot local infiltration analgesia in TKA.

Meier, Malin; Sommer, Sarah; Huth, Jochen; Benignus, Christian; Thienpont, Emmanuel; Beckmann, Johannes (2021). Local infiltration analgesia with additional intraarticular catheter provide better pain relief compared to single-shot local infiltration analgesia in TKA. Archives of orthopaedic and trauma surgery, 141(1), pp. 105-111. Springer 10.1007/s00402-020-03606-0

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PURPOSE

Local infiltration analgesia (LIA) has been proven to be efficient in total knee arthroplasty (TKA). However, the effect of single-shot LIA is temporarily limited. The objective of this prospective trial was to investigate if the potential benefits resulting from LIA can be prolonged by a continuous intra-articular perfusion of LIA. The hypothesis of the present study was that the use of an additional continuous intra-articular perfusion delivering LIA would result in less pain and better function compared to single-shot LIA in the immediate post-operative period.

METHODS

50 consecutively selected patients undergoing TKA received either a single-shot LIA (S-LIA group, 25 knees) or single-shot LIA combined with a continuous post-operative intra-articular perfusion for three post-operative days (CP-LIA group, 25 knees). VAS (visual analogue scale) for pain, pain medication consumption and flexion ability were recorded postoperatively for 6 days. All patients had the same implant, surgeon and intra- as well as post-operative setting.

RESULTS

The VAS score was significantly better for CP-LIA 6 h after surgery and on post-operative day 1, 2 and 6. There was no significant difference with regard to additional opioid consumption or flexion ability of the knee. However, there was a trend of the CP-LIA group requiring less additional opioids over the complete post-operative period compared to the S-LIA group. There were no complications or revisions.

CONCLUSION

LIA combined with an additional intra-articular catheter provides better short-term pain control compared to single-shot LIA. However, no significant differences in terms of knee flexion were observed. This limited benefit should be balanced against the additional costs and the possible higher risk of infection.

LEVEL OF EVIDENCE

Level II.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Meier, Malin Kristin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0936-8051

Publisher:

Springer

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

19 Jan 2021 13:33

Last Modified:

24 Jan 2021 03:00

Publisher DOI:

10.1007/s00402-020-03606-0

PubMed ID:

32949268

Uncontrolled Keywords:

LIA Local infiltration analgesia Perioperative pain management TKA TKR

BORIS DOI:

10.48350/150493

URI:

https://boris.unibe.ch/id/eprint/150493

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