COMPARISON OF PERI- AND INTRAARTICULAR MULTIMODAL DRUG INJECTION WITH FEMORAL AND SCIATIC NERVE BLOCK AFTER TOTAL KNEE REPLACEMENT

Abstract

Good perioperative analgesia following Total Knee Replacement facilitates rehabilitation and may reduce hospital stay. A multimodal drug injection has been shown to provide excellent pain control and functional recovery, and was introduced into the operating practice of one Arthroplasty surgeon during his Total Knee Replacements.

We compared the rehabilitation of 27 consecutive patients (group 1) following their Total Knee Replacement under spinal anaesthesia receiving the periarticular infiltration mixture, consisting of levobupivacaine, ketorolac and adrenaline at the end of surgery. Their rehabilitation was compared to group 2, a historical group operated on by the same surgeon before the introduction of the multimodal drug injection. These patients were age and sex matched and had received a Femoral and Sciatic block at the time of their operation.

Patients in group 1 had lower analgesic and anti-emetic requirements than group 2. Group 1 also had a shorter time to Strait Leg raise.

Periarticular multimodal drug injection can improve perioperative analgesia and mobilisation following Total Knee Replacement as well as reducing opioid side effects.