A randomized controlled trial on additional efficacy of local anesthetic injection on multimodal analgesia in total knee arthroplasty
10.3760/cma.j.issn.0253-2352.2016.07.004
- VernacularTitle:膝关节周围注射镇痛在全膝关节置换术后多模式镇痛方案中的作用
- Author:
Huiming PENG
;
Qiheng TANG
;
Wenwei QIAN
;
Xisheng WENG
;
Yixin ZHOU
;
Jin LIN
;
Jin JIN
;
Wei WANG
;
Bin FENG
;
Xinghua YIN
;
Longchao WANG
;
Xue TIAN
- Publication Type:Journal Article
- Keywords:
Arthroplasty,replacement,knee;
Anesthesia and analgesia;
Injections,intra-articular
- From:
Chinese Journal of Orthopaedics
2016;36(7):406-412
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the additional efficacy of local anesthetic injection (LAI) as a part of multimodal anal?gesia in patients undergoing total knee arthroplasty (TKA) with respect to pain, narcotic use, knee function and complications. Methods A multicenter randomized, controlled, double blind study was performed. A total of 101 patients undergoing unilateral TKA in two centers were randomly divided into injection group and control group. Injection group (50 cases) received local anes?thetic injection of ropivacaine (200 mg), fentanyl (1μg) and epinephrine (1∶1 000, 0.25 mg) in operation and control group (51 cas?es) did not. All patients received standardized general anesthesia and postoperative intravenous patient controlled analgesia (PCA). Preoperative baseline data, surgery?related conditions, postoperative pain (on a 0 to 10 scale), knee function, time of open?ing PCA, narcotic dosage in PCA and complications were compared respectively. Results The time of opening PCA in injection group (4-10 h, M=8 h) was longer than that in control group (2-5 h, M=4 h) (P<0.05). The 12 h, 24 h and total narcotic use of PCA in injection group (8.62±3.601 ml, 21.22±9.220 ml, 38.52±7.764 ml) was less than that in control group (18.43±9.671 ml, 35.30± 11.414 ml, 55.52±12.405 ml) (P<0.05). At post anesthesia care unit the mean VAS in injection group (2.40±1.927) was lower than that in control group (3.06 ± 2.073) (P<0.05). There was no difference in mean VAS at other time points, knee function, length of stay between two groups (P>0.05). Conclusion LIA in TKA can relieve pain early after TKA, prolong the time of opening PCA and reduce narcotic use compared with patients without it. It is simple and safe to use.
