PERIARTICULAR BUPIVACAINE INJECTION IN KNEE ARTHROPLASTY A RANDOMIZED

Abstract

Background: Different modes of analgesia have been reported for patients undergoing total knee
arthroplasty. Postoperative analgesia with the use of parenteral opioids or epidural analgesia can be
associated with side effects. Pain relief is important for postoperative knee rehabilitation, and it may
influence the overall outcome, improves patient satisfaction, and may reduce the hospital stay. We
investigated the analgesic effect of locally injected drugs around a total knee prosthesis.
Methods: Sixty-two patients undergoing total knee arthroplasty were randomized either to receive either
(1) a perioperative infiltration mixture, consisting of local anesthetic, and Parenteral narcotics or (2)
parenteral narcotics only. Pain control, narcotic consumption, medication side effects, and postoperative
rehabilitation were monitored.
Results: The patients who had received the perioperative infiltration mixture used significantly less
parenteral narcotic analgesia over the first twenty-four hours after the surgery. They had higher visual
analog scores for patient satisfaction. Neither complications nor side effects related to the infiltration of the
local anesthetic were observed.
Conclusions: Periarticular injection of a local anesthetic offered improved pain control and significantly
reduce the requirements for parenteral narcotic analgesia with minimal side effects to patients undergoing
total knee arthroplasty.