Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
No advantage of adrenaline in the local infiltration analgesia mixture during total knee arthroplasty.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Pooled it
- Efficacy of epinephrine in local infiltration analgesia on pain relief and opioid consumption following total knee arthroplasty: a randomized controlled trial.Acta orthopaedica · 2023Trial
- Continuous Cold Flow Device Following Total Knee Arthroplasty: Myths and Reality.Medicina (Kaunas, Lithuania) · 2022Trial
- Reduced opiate use after total knee arthroplasty using computer-assisted cryotherapy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Trial
- Local infiltration analgesia adds no clinical benefit in pain control to peripheral nerve blocks after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Trial
- The effect of adding dexamethasone to adductor block and IPACK block on acute postoperative, rebound, and chronic pain following knee arthroplasty-1-year follow-up.Frontiers in medicine · 2025Article
- Periarticular injection, iPACK block, and peripheral nerve block in pain management after total knee arthroplasty: a structured narrative review.Perioperative medicine (London, England) · 2023Review
- The Impact of Perioperative Multimodal Pain Management on Postoperative Outcomes in Patients (Aged 75 and Older) Undergoing Short-Segment Lumbar Fusion Surgery.Pain research & management · 2022Article
- Injectable electrospun fiber-hydrogel composite sequentially releasing clonidine and ropivacaine for prolonged and walking regional analgesia.Theranostics · 2022Article
- Increase in early wound leakage in total knee arthroplasty with local infiltrative analgesia (LIA) that includes epinephrine: a retrospective cohort study.Acta orthopaedica · 2020Article
- Is changing the postoperative pain management in total knee arthroplasty from femoral nerve block to local infiltration analgesia successful? Retrospective trial with the first and last 100 patients.Journal of orthopaedic surgery and research · 2020Article
- LIA in arthroplasty - the history of a single-center observational study leading to implementation in general clinical practice.Acta orthopaedica · 2020Article
- Opioid-Free Total Knee Arthroplasty? Local Infiltration Analgesia Plus Multimodal Blood-Loss Prevention Make it Possible.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2019Article
- [Background and current use of adjuvants for regional anesthesia : From research to evidence-based patient treatment].Der Anaesthesist · 2019Review
- Single Local Infiltration Analgesia (LIA) Aids Early Pain Management After Total Knee Replacement (TKR): An Evidence-Based Review and Commentary.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2018Review
- Low incidence of postoperative urinary retention with the use of a nurse-led bladder scan protocol after hip and knee arthroplasty: a retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2018Article
- Physical activity after outpatient surgery and enhanced recovery for total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Observational
- Patient selection criteria for outpatient joint arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLocal infiltration analgesia (LIA) is widely applied in patients undergoing total knee arthroplasty (TKA). In daily practice, adrenaline is added to the LIA mixture to achieve vasoconstriction. However, adrenaline has some possible negative side effects (e.g. tissue necrosis). This trial investigated whether ropivacaine alone is at least as effective for postoperative pain relief after LIA.
methodsFifty patients scheduled for primary TKA were included in this prospective randomized, double-blind, controlled pilot study receiving high-volume (150 mL) single-shot intra-capsular LIA with ropivacaine (2 %) with (Ropi+) or without (Ropi-) adrenaline (0.01 %). All patients received the same pre-, peri- and postoperative care with multimodal oral pain protocol. Postoperative pain was assessed before and after the first mobilization and during the first 48 h postoperative using the visual analogue scale (VAS). Secondary outcomes were rescue medication use, early mobilization, length of hospital stay, adverse events (AE's) and readmission rates. Patient reported outcomes measures (PROMS); Oxford Knee Score and WOMAC, were obtained preoperative and 3 months postoperative.
resultsVAS scores were not significantly different before (n.s.) and after the first mobilization (n.s.), neither over the first 48 h postoperative (n.s.). Patients who needed rescue medication (n.s.), who mobilized <6 h postoperative (n.s.), who were discharged before postoperative day 3 (n.s.), AE's and readmission rate (n.s.) were comparable between both groups. At 3-month follow-up, PROMS significantly improved within both groups.
conclusionTo prevent possible negative side effects (e.g. tissue necrosis), adrenaline should be omitted from the LIA mixture. Single-shot LIA with ropivacaine alone results in clinical acceptable adequate pain control and can be used in daily TKA practice. LEVEL OF EVIDENCE: Randomized, double-blind, prospective clinical trial, Level I.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.