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Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty

Acta orthopaedica, 2015-06, Vol.86 (3), p.373-377 [Peer Reviewed Journal]

Copyright: © Nordic Orthopaedic Federation 2014 ;ISSN: 1745-3674 ;ISSN: 1745-3682 ;EISSN: 1745-3682 ;DOI: 10.3109/17453674.2014.991629

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  • Title:
    Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty
  • Author: Ali, Abdulemir ; Sundberg, Martin ; Hansson, Ulrik ; Malmvik, Johan ; Flivik, Gunnar
  • Subjects: Clinical Medicine ; Klinisk medicin ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Orthopedics ; Ortopedi
  • Is Part Of: Acta orthopaedica, 2015-06, Vol.86 (3), p.373-377
  • Description: Background and purpose - Local infiltration analgesia (LIA) is well established for effective postoperative pain relief in total knee arthroplasty (TKA). To prolong the effect of LIA, infusion pumps with local intraarticular analgesia can be used. We evaluated the effect of such an infusion pump for the first 48 h postoperatively regarding pain, knee function, length of stay (LOS) in hospital, and complications. Patients and methods - 200 patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at 2 mL/h. The patients were randomized either to ropivacaine (7.5 mg/mL) or to NaCl (9 mg/mL) in the pump. Visual analog scale (VAS) pain (0-100 mm), analgesic consumption, side effects of medicine, range of motion (ROM), leg-raising ability, LOS, and complications during the first 3 months were recorded. Results - On the first postoperative day, the ropivacaine group had lower VAS pain (33 vs. 40 at 12 noon and 36 vs. 43 at 8 p.m.; p = 0.02 and 0.03, respectively), but after that all recorded variables were similar between the groups. During the first 3 months, the ropivacaine group had a greater number of superficial and deep surgical wound infections (11 patients vs. 2 patients, p = 0.02). There were no other statistically significant differences between the groups. Interpretation - Continuous intraarticular analgesia (CIAA) with ropivacaine after TKA has no relevant clinical effect on VAS pain and does not affect LOS, analgesic consumption, ROM, or leg-raising ability. There may, however, be a higher risk of wound-healing complications including deep infections.
  • Publisher: Nordic Orthopaedic Federation
  • Language: English
  • Identifier: ISSN: 1745-3674
    ISSN: 1745-3682
    EISSN: 1745-3682
    DOI: 10.3109/17453674.2014.991629
  • Source: PubMed
    Geneva Foundation Free Medical Journals at publisher websites
    Directory of Open Access Journals
    Alma/SFX Local Collection
    SWEPUB Freely available online
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