Prospective Study of Efficacy of Local Infiltration Analgesia and Epidural Analgesia in Patients Undergoing Total Knee Replacements

Y, Manjunath Hanjagi; Varkey, Prasad; Prakash, .

doi:10.14260/jemds/2017/696

Cited by 3 publications

(4 citation statements)

References 36 publications

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“…However, improvements in pain control deserve the greatest credit for the more rapid recoveries that are now being seen [5] . Arthrofibrosis and diminished range of movements are closely related to degree of post-operative pain [6] . Hence, pain control after total knee arthroplasty (TKA) is of prime importance in the immediate postoperative period for early rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of local infiltration analgesia in the early postoperative period after total knee replacement

Hiregoudar¹,

Hiregoudar²

2023

Int. J. Orthop. Sci.

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Background: Total knee replacement (TKR) is a commonly performed surgical procedure, all across the world. TKR may be associated with severe postoperative pain, usually requiring prolonged hospital stay and relative immobilization of the patient, may cause unwanted medical problems like nosocomial infections, DVT and poor surgical outcome. Local infiltration analgesia (LIA) is becoming more commonly used owing to the excellent pain relief, the low frequency of complications, and the antiinflammatory effect. The injection usually contains a mixture of an anesthetic drug and a NSAID, to which epinephrine or a corticosteroid can be added. LIA is easy to use, relatively cheap, and many authors concluded that it reduces pain and opioid consumption. Objectives:1. To assess the pain relief postoperatively using visual analogue score (VAS). 2. To assess the knee range of movements (knee flexion and extensor lag) postoperatively. Methods and Methodology:This study is an observational clinical study, centered at a private hospital between March 2019 to October 2020. Data was collected from 42 patients undergoing total knee replacement with local infiltration analgesia between the periods from March 2019 to 2020 October. Written and informed consent was taken. Patients with allergy to any of the study drugs, uncontrolled diabetes and hypertension were excluded from the study. A local infiltration injection of a mixture (cocktail) of drugs ropivacaine, ketorolac, adrenaline and normal saline was given using spinal needle. Quality of analgesia was estimated by using visual analogue score of 0 to 10 at 6 hr, 24hr, 48 hr, and 72hr after surgery during the rest and movement and knee range of movements was assessed postoperatively using goniometer. Data was collected and entered in excel sheet and was analyzed using paired t test. Software SPSS 20 was used for the statistical analysis. A P value of <0.001% was considered significant. Results: A total of 42 patients with Osteoarthritis knee undergoing TKR with LIA were included in the study. A local infiltration injection of a mixture (cocktail) of drugs listed above was given before and after the implantation of the components. VAS, KF and EL was measured postoperatively at 6hrs, 24hrs, 48 hrs, 72 hrs respectively. Our results showed that postoperative VAS was significantly better till 48 hours postoperatively. KF improved significantly postoperatively. There was improvement in the extensor lag from postoperative day three.

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Section: Discussionmentioning

confidence: 99%

“…Hence, pain control after total knee arthroplasty (TKA) is of prime importance in the immediate postoperative period for early rehabilitation. LIA is a Technique for management of acute phase of postoperative pain, particularly after knee and hip surgery [7,8] . It was developed by Dr. Dennis Kerr and Dr. Lawrence Kohan in Sydney.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of local infiltration analgesia in the early postoperative period after total knee replacement

Hiregoudar¹,

Hiregoudar²

2023

Int. J. Orthop. Sci.

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“…However, this surgery is potentially associated with a series of complications such as infection, implant loosening, thromboembolic disease, implant fracture and readmission. (10,11) Although, there are different studies evaluating the outcomes of total knee arthroplasty in the world, this topic has not been assessed in our region, Babol, northern Iran, yet and we do not have any data to see if total knee arthroplasty is associated with acceptable outcomes or not. Therefore, this study was performed with the aim of evaluating the outcomes of total knee arthroplasty in Babol.…”

mentioning

confidence: 98%

A Prospective Study on Total Knee Arthroplasty Outcomes in North of Iran

Gharajeh¹,

Janmohammadi²,

Esmaeilnejad-Ganji³

2018

jemds

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“…Others included joint dislocation, bone fractures and prosthesis, deep venous thrombosis, nerve injury and remained pain. (8)(9)(10) It was reported that some factors can affect the surgery outcomes including demographic (Age, sex, ethnicity), social behaviours (Occupation, smoking, exercise), associated disease (Rheumatoid arthritis, diabetes) and place of health service reception (Governmental/ Private hospitals, trainings after the discharge). (11,12) Considering the increasing trend in total hip and knee replacements and the serious post-operative complications and also given the limited information on the outcomes of the two surgeries in Iran, we aimed to assess the results of the total hip and knee arthroplasty and the related factors in north of Iran.…”

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confidence: 99%