Evidence map›Paper›PMID 28468607›Full record

Trial reportBMC anesthesiology2017

Does local infiltration analgesia reduce peri-operative inflammation following total hip arthroplasty? A randomized, double-blind study.

J Kuchálik, A Magnuson, E Tina, A Gupta

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03671746 (Inflammatory Response to Trauma - Does Early Cytokine Modulation Improve Patient Outcome), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT03671746 phase1completednot on this mapstarted 2019, after this paper: background citation

Inflammatory Response to Trauma - Does Early Cytokine Modulation Improve Patient Outcome

TypeinterventionalSponsorArun AnejaRan2019 to 2023Enrolled70ConditionsPolytraumaArmsKetorolac, Saline Solution
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

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  3. [Analgesic effect of a new "cocktail" of local infiltration analgesia after total hip arthroplasty-A prospective randomized controlled study].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

J KuchálikDepartment of Anesthesiology and Intensive Care, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
A MagnusonClinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
E TinaClinical Research Laboratory, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
A GuptaPerioperative Medicine and Intensive Care, Institution for Physiology and Pharmacology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden. anil.gupta@sll.se.ORCID 0000-0001-6128-7752
Örebro University · SEKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative inflammation following total hip arthroplasty (THA) can lead to delayed mobilization and return of hip function. Our primary aim was to assess whether local infiltration analgesia (LIA) during surgery can prevent postoperative inflammation.

methodsThis is a sub-analysis of data from a broader double-blind study where 56 patients received spinal anaesthesia for THA. Additionally, Group FNB (Femoral Nerve Block) received an ultrasound-guided femoral nerve block using 30 mL of ropivacaine 7.5 mg/mL (225 mg), and 151.5 mL of saline peri-articularly intra-operatively. Group LIA received 30 mL saline in the femoral nerve block and ropivacaine 2 mg/mL, 300 mg (150 mL) + ketorolac 30 mg (1 mL) + adrenaline 0.5 mg (0.5 mL) peri-articularly. After 23 h, the LIA mixture (22 mL) was injected via a catheter placed peri-articularly in Group LIA and 22 mL saline in Group FNB. A battery of pro- and anti-inflammatory cytokines was assessed using a commercially available kit preoperatively and after 4 h and 3 days postoperatively. Additionally, CRP, platelet count and white blood count was determined pre- and postoperatively.

resultsThere was a general trend towards an increase in pro-inflammatory cytokines postoperatively, which returned to normal levels after 3 days. IL-6 concentration was significantly lower 4 h postoperatively in Group LIA compared to Group FNB (p = 0.015). No other significant differences were found between the groups in other cytokines. CRP levels were significantly higher in Group FNB compared to Group LIA 3 days postoperatively (p < 0.001). No other significant differences were seen between the groups.

conclusionLocal infiltration analgesia has a modest but short-lasting effect on postoperative inflammation in patients undergoing total hip arthroplasty. This is likely to be due to local infiltration of ketorolac and/or local anaesthetics in the LIA mixture. Future studies should be directed towards assessing whether the use of LIA translates into better patient outcomes.

trial registrationEudraCT Number 2012-003875-20 . Registered 3 December 2012.

Indexed as

Nerve BlockAmidesAnesthetics, LocalAnti-Inflammatory Agents, Non-SteroidalArthroplasty, Replacement, HipC-Reactive ProteinCytokinesDouble-Blind MethodFemaleFemoral NerveHumansInflammationKetorolacMaleMiddle AgedPostoperative ComplicationsAmidesAnesthetics, LocalAnti-Inflammatory Agents, Non-SteroidalC-Reactive ProteinCytokinesKetorolacRopivacaineLocal infiltration analgesiaPostoperative inflammationTotal hip arthroplasty

Identifiers

PMID28468607
PMCPMC5415732
OpenAlexW2611030121

What OpenQuestion holds

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Registered trials

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.