Aims. The aim of this study was to compare the effectiveness of a femoral
nerve block and a periarticular infiltration in the management of
early post-operative pain after total knee arthroplasty (TKA). Patients and Methods. A pragmatic, single centre, two arm parallel group, patient blinded,
randomised controlled trial was undertaken. All patients due for
TKA were eligible. Exclusion criteria included contraindications
to the medications involved in the study and patients with a neurological
abnormality of the lower limb. Patients received either a femoral
nerve block with 75 mg of 0.25% levobupivacaine hydrochloride around
the nerve, or periarticular infiltration with 150 mg of 0.25% levobupivacaine
hydrochloride, 10 mg morphine sulphate, 30 mg ketorolac trometamol
and 0.25 mg of adrenaline all diluted with 0.9% saline to make a
volume of 150 ml. Results. A total of 264 patients were recruited and data from 230 (88%)
were available for the primary analysis. Intention-to-treat analysis
of the primary outcome measure of a visual analogue score for pain
on the first post-operative day, prior to physiotherapy, was similar
in both groups. The mean difference was -0.7 (95% confidence interval
(CI) -5.9 to 4.5; p = 0.834). The periarticular group used less
morphine in the first post-operative day compared with the femoral nerve
block group (74%, 95% CI 55 to 99). The
Objective: The aim of this prospective observational study was to evaluate the feasibility of performing ACL reconstruction with
Objective: The aim of this prospective observational study was to evaluate the feasibility of performing ACL reconstruction with
We randomised 50 patients with extracapsular fractures of the femoral neck to receive either a bupivacaine
Objectives. The goal of this retrospective study was to compare two different processes of pain control after total knee arthroplasty (TKA): local anesthesia versus
We performed a randomized feasibility trial to examine the impact of preoperative
Introduction: Inadequate control of postoperative pain after total knee arthroplasty (TKA) has been associated with a poor functional recovery. This study investigated whether the addition of a single injection
Background:. Total knee replacement (TKR) is a frequent and effective surgery for knee osteoarthritis. Postoperative pain is under concern and can be relieved by different methods, including
Our study is still in progress. The results mentioned in the abstract are preliminary results. The final results will be provided at the time of presentation. Over the past decade, the widespread availability of high-resolution ultrasonography coupled with advances in regional anaesthesia have popularised peripheral nerve blocks for anterior cruciate ligament reconstructions (ACLRs). The aim of this study is to investigate whether the
Background. Total knee arthroplasty is associated with early postoperative pain. Appropriate pain management is important to facilitate postoperative rehabilitation and positive functional outcomes. This study compares outcomes in TKA with three techniques; local infiltration analgesia, single shot
Total knee arthroplasty is associated with early postoperative pain. Appropriate pain management is important to facilitate postoperative rehabilitation and positive functional outcomes. This study compares outcomes in TKA with three techniques; local infiltration analgesia, single shot
Purpose. To evaluate the effectiveness of post-operative pain management using the intra-operative peri-articular injection(PAI) and/or electromyography (EMG)-guided preoperative
Purpose: Continuous
The purpose of this double-blinded prospective study was to evaluate the effectiveness of electromyography (EMG)-guided preoperative
A prospective randomised study was carried out to compare two methods of pain control following arthroscopically assisted ACL reconstruction. Twenty patients each were randomly recruited to receive either
In a randomised controlled pragmatic trial we
investigated whether local infiltration analgesia would result in earlier
readiness for discharge from hospital after total knee replacement
(TKR) than patient-controlled epidural analgesia (PCEA) plus femoral
nerve block. A total of 45 patients with a mean age of 65 years
(49 to 81) received a local infiltration with a peri-articular injection
of bupivacaine, morphine and methylprednisolone, as well as adjuvant
analgesics. In 45 PCEA+femoral nerve blockade patients with a mean
age of 67 years (50 to 84), analgesia included a bupivacaine nerve
block, bupivacaine/hydromorphone PCEA, and adjuvant analgesics.
The mean time until ready for discharge was 3.2 days (1 to 14) in
the local infiltration group and 3.2 days (1.8 to 7.0) in the PCEA+femoral
nerve blockade group. The mean pain scores for patients receiving
local infiltration were higher when walking (p = 0.0084), but there
were no statistically significant differences at rest. The mean
opioid consumption was higher in those receiving local infiltration. The choice between these two analgesic pathways should not be
made on the basis of time to discharge after surgery. Most secondary
outcomes were similar, but PCEA+femoral nerve blockade patients
had lower pain scores when walking and during continuous passive
movement. If PCEA+femoral nerve blockade is not readily available, local
infiltration provides similar length of stay and similar pain scores
at rest following TKR. Cite this article: