Local Infiltration Analgesia versus Standard Analgesia in Total Knee Arthroplasty

Abstract

Purpose.To compare outcome and cost following local infiltration analgesia (LIA) versus standard analgesia in total knee arthroplasty (TKA). Methods. 13 men and 33 women (mean age, 67.5 years) underwent TKA by a single surgeon and received LIA (n=24) or standard analgesia (n=22), depending on the availability of the senior anaesthetist. Results. The 2 groups were comparable at baseline in terms of age, gender, body mass index, American Society of Anesthesiologists score, and range of motion. Compared with the standard analgesia group, the LIA group resulted in a shorter mean length of hospital stay (4.9 vs. 2.7 days, p<0.0001) and higher proportion of patients able to straight leg raise on discharge (38% vs. 86%, p=0.0011), as well as lower pain scores in the first 3 days and greater range of motion at all time points. Respectively in the standard analgesia and LIA groups, the mean cost per patient for all analgesic medication was A$129.25Local infiltration analgesia versus standard analgesia in total knee arthroplasty

Can local infiltration analgesia increase satisfaction in postoperative short-term pain control in total knee arthroplasty?

“…4,26,27 We decide to compare FNB associating LIA because previous studies had well indicated the effectiveness of these two methods in relieving pain after knee replacement surgery. 18,20,22,35,37 Andersen and Kehlet 13,1428 and Xu et al 29 published recent reviews and studies about the effects of LIA in TKA. They concluded that LIA provides effective analgesia in the initial postoperative period after TKA in most randomized clinical trials even when combined with multimodal systemic analgesia.…”

Authors' Reply

“…We read with interest the article by Suthersan et al 1 We would like to discuss our experience: 1. Patients with severe varus/valgus deformity should be excluded, because of their increased analgesic requirement and thus delayed rehabilitation.…”

Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis

“…Local infiltration analgesia (LIA) has a short duration of analgesic action, which limits its clinical application. 7 A previous study reported that periarticular infiltration analgesia was effective and safe to reduce perioperative pain during the first 36 hours after TKA. 8 , 9 Its effects diminish with time, but this does not modify the postoperative course or the patient’s satisfaction at short-term follow-up.…”