2017 ISAKOS Biennial Congress ePoster #1229
A Double Blinded, Randomized, Controlled Proof of Concept Study to Compare Post-Operative Analgesic and Mobilization Outcomes of Local Infiltration Analgesia, Single Shot Femoral Nerve Block and Intrathecal Morphine in Primary Total Knee Arthroplasty
Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, Adelaide, SA AUSTRALIA
Jason Koerber, MD, Adelaide AUSTRALIA
Amy Watts, MD, Adelaide AUSTRALIA
Steven Quinn, MD, Adelaide AUSTRALIA
Daniel Mangos, MD, Adelaide AUSTRALIA
Jegan Krishnan, Prof., Adelaide, SA AUSTRALIA
The Repatriation General Hospital, Adelaide, SA, AUSTRALIA
FDA Status Cleared
Summary
An RCT of Local Anesthetic Infiltration in Total Knee Arthroplasty
ePosters will be available shortly before Congress
Abstract
Total knee arthroplasty is associated with early postoperative pain. Appropriate pain management is important to facilitate postoperative rehabilitation and positive functional outcomes. This Randomized, Controlled and Blinded study compares outcomes in TKA with three techniques; local infiltration analgesia, single shot femoral nerve block and intrathecal morphine.
Forty-five patients undergoing elective primary Total Knee Arthroplasty (TKA) with were randomized into one of three groups. The surgeons and anesthetists were blinded to which group patients were allocated to.
Study arm 1 received Local infiltration ropivacaine intra-operatively, an elastomeric device of ropivacaine for 24 hours. Study arm 2 received a Femoral Nerve Block ropivacaine with placebo local infiltration analgesia and placebo intrathecal morphine. Study arm 3 received intrathecal morphine, placebo femoral nerve block and placebo local infiltration analgesia. All patients received standardized medications and were reviewed blinded by the physio and research team
Length of stay was lowest in the LIA group although LIA and FNB were better than control. LIA had the lowest use of analgesics at all time points. LIA had the best pain VAS scores (P=0.06) There was no significant difference in nausea scores.
Performed a complex study with Blinding and Randomisation. LIA showed good Improvement in Pain VAS, Analgesic Consumption & LOS. There were no Significant complications from Local Infiltration. We have also enhanced our overall culture of early mobilisation