2017
DOI: 10.5005/jp-journals-10046-0060
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Multimodal Cocktail Injection relieves Postoperative Pain and improves Early Rehabilitation following Total Knee Replacement: A Prospective, Blinded and Randomized Study

Abstract: Objectives: An effective postoperative analgesia following total knee arthroplasty (TKA) would shorten the rehabilitation period and improve patient satisfaction. The primary objective of the present study is to test the hypothesis that intraoperative multimodal cocktail injection can significantly reduce the consumption of analgesics and duration of time required to perform straight-leg raise, and improve range of motion (ROM) and patient satisfaction rate following TKA. Materials and methods:A total of 126 o… Show more

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“…The delay in rehabilitation was due to inadequate pain relief owing to delayed union and repeated surgical intervention for established pseudarthrosis. During the course of study, authors noticed that post-surgical pain delayed early rehabilitation and thus negatively affected patients' satisfaction rate and functional outcomes [37]. In the current study, we started to use PFR as an additional procedure to decompress the medial compartment more efficiently.…”
Section: Discussionmentioning
confidence: 87%
“…The delay in rehabilitation was due to inadequate pain relief owing to delayed union and repeated surgical intervention for established pseudarthrosis. During the course of study, authors noticed that post-surgical pain delayed early rehabilitation and thus negatively affected patients' satisfaction rate and functional outcomes [37]. In the current study, we started to use PFR as an additional procedure to decompress the medial compartment more efficiently.…”
Section: Discussionmentioning
confidence: 87%
“…Morphine acts on opiate receptors and reduces transmission of pain signals and cefuroxime acts as an antibiotic cover reducing chances of post-op infection. Methylprednisolone acts by attenuating the neuroendocrine stress response, inhibiting pro inflammatory pathways and by counteracting vasodilatory effects of prostaglandins [21][22][23] . Usage of LIA is also found to reduce opioid utilization and its systemic adverse effects to patients by the long lasting effects of bupivacaine which is one of the components in the Ranawat Cocktail (ROC) regimen.…”
Section: Discussionmentioning
confidence: 99%
“…All these beneficial effects of LIA cocktail ensures that the TKA patients have a reduced hospital stay thereby reducing their chances of nosocomial infections due to signicant reduction in post-op pain and also early and adequate mobilization [24] . The use of LIA has also been linked with better patient satisfaction, decreased opioid consumption and reduced operative site complications [14,22,25] . The main disadvantages of LIA is usually seen due to the high doses of local anaesthetic used in the cocktail and is associated with cardiotoxicity and CNS toxicity in some elderly patients which may be lethal and are thus relative contraindications in such patients [26] .…”
Section: Discussionmentioning
confidence: 99%