Comparison of Periarticular Infiltration and Combination Delivery of Local Anesthetics for Reducing Pain and Opioid Consumption after Total Knee Arthroplasty.

The Journal of Knee Surgery
Derek T WardAlfred C Kuo

Abstract

Surgical-site delivery of local anesthetics decreases pain and opioid consumption after total knee arthroplasty (TKA). The optimal route of administration is unknown. We compared local anesthetic delivery using periarticular soft-tissue infiltration to delivery using a combination of preimplantation immersion and intra-articular injection (combination treatment). The records of patients who underwent unilateral, cemented, primary TKA with spinal anesthesia and adductor canal blocks at a single Veterans Affairs Medical Center were retrospectively reviewed. Three subgroups were compared, including controls who did not receive additional local anesthetics, patients who received periarticular infiltration, and patients who received combination treatment. Mean daily pain scores and mean 24-hour opioid consumption on postoperative days (PODs) 0 and 1 were calculated, and analysis of variance was used to assess for significant differences. Factors that were associated with lower pain scores and opioid consumption were then identified using multivariate stepwise regression. There were 26 controls, 25 periarticular infiltration patients, and 39 combination patients. The periarticular infiltration cohort had significantly lower mean pain...Continue Reading

References

Mar 21, 2003·The Annals of Thoracic Surgery·Richard P AndersonGary L Grunkemeier
May 3, 2006·The Journal of Bone and Joint Surgery. American Volume·Constant A BuschRichard W McCalden
Jun 10, 2011·The Journal of Bone and Joint Surgery. American Volume·Javad ParviziKishor Gandhi
Jan 25, 2016·The Journal of the American Academy of Orthopaedic Surgeons·Calin Stefan MouchaEmily J Levin
Apr 18, 2017·The Journal of Arthroplasty·Nicholas A BedardJohn J Callaghan
Jun 13, 2017·The Journal of Arthroplasty·Jeremy A RossWilliam A Jiranek
Jun 22, 2017·The Journal of Arthroplasty·Alfred C Kuo, Eva Grotkopp
Jul 19, 2017·The Journal of Knee Surgery·Randa K ElmallahMichael A Mont
Sep 21, 2017·The Journal of Arthroplasty·Katherine HadlandsmythBrian C Lund
Dec 5, 2017·The Journal of Arthroplasty·Cary S PolitzerThorsten M Seyler
May 14, 2018·The Journal of Arthroplasty·Robert S NambaMaria C S Inacio

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