Trial reportActa orthopaedica2011
Intraarticular vs. extraarticular ropivacaine infusion following high-dose local infiltration analgesia after total knee arthroplasty: a randomized double-blind study.
Trial report in Acta orthopaedica, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 36 citations in OpenAlex.
- No advantage of adrenaline in the local infiltration analgesia mixture during total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Trial
- [Postoperative analgesia after total knee arthroplasty: Continuous intra-articular catheter vs. continuous femoral nerve block].Der Orthopade · 2015Trial
- Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty: a randomized double-blind study of 200 patients.Acta orthopaedica · 2015Trial
- Intraarticular analgesia versus epidural plus femoral nerve block after TKA: a randomized, double-blind trial.Clinical orthopaedics and related research · 2014Trial
- Article
- Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives.Journal of pain research · 2020Review
- Enhanced recovery after posterior minimally invasive total hip arthroplasty with continuous intraarticular anaesthesia.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2018Article
- Comparison of the effects of intra-articular sole ropivacaine and combined ketorolac and ropivacaine for pain control after knee arthroscopy surgery.British journal of pain · 2015Article
- Local Anaesthetic Infiltration and Indwelling Postoperative Wound Catheters for Patients with Hip Fracture Reduce Death Rates and Length of Stay.Surgery research and practice · 2015Article
- Preventive analgesia by local anesthetics: the reduction of postoperative pain by peripheral nerve blocks and intravenous drugs.Anesthesia and analgesia · 2013Review
- Continuous local anesthetic wound infusion: Impact on pain score and opioid use in patients undergoing elective mastectomy.Saudi journal of anaesthesiaArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeRopivacaine infusion following high-volume local infiltration analgesia has been shown to be effective after total knee arthroplasty, but the optimum site of administration of ropivacaine has not been evaluated. We compared the effects of intraarticular and extraarticular adminstration of the local anesthetic for postoperative supplementation of high-volume local infiltration analgesia. PATIENTS AND
methodsIn this double-blind study, 36 rheumatic patients aged 51-78 years with physical status ASA 2-3 who were scheduled for total knee arthroplasty were randomized into 2 groups. All patients received wound infiltration at the end of surgery with 300 mg ropivacaine, 30 mg ketorolac, and 0.5 mg epinephrine (total volume 156 mL). A tunneled catheter was randomly placed either extraarticularly or intraarticularly. Continuous infusion of ropivacain (0.5%, 2 mL/h) was started immediately and was maintained during the next 48 h. Pain intensity at rest, on movement, and with mobilization was estimated by the patients and the physiotherapist; rescue morphine consumption was recorded.
resultsAs estimated by the patients, ropivacaine administered intraarticularly did not improve analgesia relative to extraarticular infusion, but improved the first mobilization. The incidence of high intensity of pain (VAS 7-10) was less in the group with intraarticular infusion. Analgesic requirements were similar in the 2 groups (47 mg and 49 mg morphine). No complications of postoperative wound healing were seen and there were no toxic side effects.
interpretationContinuous infusion of ropivacaine intraarticulary did not improve postoperative analgesia at rest relative to extraarticular administration, but it appeared to reduce the incidence of high pain intensity during first exercises, and could therefore be expected to improve mobilization up to 24 h after total knee arthroplasty.
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