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Abstract

Orthopedic Research Online Journal

Local Infiltration Analgesia with Anterior Total Hip Arthroplasty under General Anaesthesia does Reduce Opioids Consumption and Pain: A Randomized, Double- Blind, Placebo-Controlled Trial Involving 106 Patients

  • Open or CloseYannick NT Van Den Eeden1*, Frank MC Van Den Eeden2, Fatih Yesilkaya3 and Bruno JG De Turck4

    1 Department of Orthopaedics, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292 Trier Germany

    2 Van den Eeden Hip Clinic, AZ Sint Elisabeth, Zottegem , Belgium

    3 Vrije University Medical Center of Amsterdam, The Netherlands

    4 Department of Anaesthesiology, AZ Sint Lucas, Gent, Belgium

    *Corresponding author: Yannick NT Van Den Eeden, Department of Orthopaedics, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292 Trier, Germany

Submission: August 22, 2018;Published: September 25, 2018

DOI: 10.31031/OPROJ.2018.04.000586

ISSN : 2576-8875
Volume4 Issue3

Abstract

Background: High-volume local infiltration analgesia (LIA) is widely used in total hip arthroplasty (THA) to reduce postoperative pain and opioid requirements. The efficacy of LIA in THA with different approaches to the joint remains unclear. Therefore, we examined whether intraoperative highvolume LIA in addition to a multimodal oral analgesic regimen, with direct anterior approach (DAA) for total hip arthroplasty (THA) under general anaesthesia, would further reduce acute postoperative pain and early opioid requirements consumption..

methods: In total 106 patients were recruited. Patients scheduled for unilateral, primary DAA THA under general anaesthesia were included in this randomized, double-blind, placebo-controlled trial receiving high-volume (150ml) wound infiltration with ropivacaine 0.2%, epinephrine (10μg/ mL) and Ketorolac (30mg) or 150ml saline 0.9% to evaluate the effect on early postoperative opioid consumption and on acute postoperative pain. The primary endpoint was opioid consumption 24hrs after surgery. The secondary endpoints were visual analogue pain-scale scores mobilized at 4hrs with full weight bearing and at rest at 1hr, 2hrs, 3hrs, 12hrs, 24hrs after surgery. The chronic analgesic consumption and surgical result at 6 weeks and 1 year after surgery were investigated.

Results: Wound infiltration with LIA did reduce postoperative opioid requirements. The average pain level 4hrs postoperatively mobilized was less in the LIA group. The rehabilitation progress or chronic pain after 6 weeks and 1 year showed no difference between both groups.

Conclusion: : LIA was effective reducing opioid consumption and diminishing postoperative pain during mobilization using DAA THA under general anaesthesia.

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