2017 ISAKOS Biennial Congress ePoster #1263

 

Peri Articular Injection Of Local Anaesthesia Can Replace Epidural Analgesia After Total Knee Arthroplasty: A Randomised Controlled Study

Dinesh Mohan-Choudary, MS(Orth), Chennai INDIA
APOLLO HOSPITAL, CHENNAI, TAMIL NADU, INDIA

FDA Status Cleared

Summary

PAI can replace conventional Epidural analegesia for controlling post-operative pain after TKA

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Abstract

Introduction

Postoperative analgesia following Total Knee Arthroplasty (TKA) with the use of parenteral opioids or epidural analgesia
can be associated with important side effects.Periarticular injection(PAI) is becoming more commonly utilized for pain
relief following total knee arthroplasty.Previous studies have evaluated the effect of PAI using multimodal analgaesic protocols,
but the concomitant use of epidural analgesia(EA) or patient controlled analgesia (PCA) may have masked the
genuine effects of PAI. We investigated the efficacy of PAI compared with epidural analgesia and determined whether
conventional Epidural analgesia can be effectively replaced with PAI after TKA

Methods

Eighty patients undergoing unilateral TKA were randomised into two groups. The EA group consisted of patients who
used epidural analgesia after surgery, while the PAI group included patients who did not use Epidural analegesia postoperatively
but were given PAI during surgery. We measured changes in visual analogue scale (VAS) scores, straight leg
raising (SLR), range of motion (ROM) and consumption of antiemetics or analgaesics.

Results

Pain levels in the PAI group were significantly lower than in the EA group during two weeks post-operatively (p<0.05).;
functional recovery in the SLR test showed no difference between groups (p>0.05).; mean ROM showed no difference;
(p>0.05) and there was no difference in the number of patients who needed additional analgesics. However, antiemetic
use was significantly lower for the PAI group (p<0.05). The prevalences of nausea on the night of surgery and
postoperative day 1 and of pruritus were significantly lower in the periarticular injection group than in the epidural
analgesia group.

Discussion And Conclusion

PAI offered better post operative pain relief and minimal side effects compared with epidural analgesia. Thus, PAI can
replace conventional Epidural analegesia for controlling post-operative pain after TKA

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