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High-volume infiltration analgesia in bilateral hip arthroplasty

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  • Lasse Ø Andersen
  • Niels Kristian Stahl Otte
  • Henrik Husted
  • Lissi Gaarn-Larsen
  • Billy Kristensen
  • Kehlet, Henrik
Background and purpose High-volume infiltration analgesia may be effective in postoperative pain management after hip arthroplasty but methodological problems prevent exact interpretation of previous studies. Methods In a randomized, double-blind placebo-controlled trial in 12 patients undergoing bilateral total hip arthroplasty (THA) in a fast-track setting, saline or high-volume (170 mL) ropivacaine (0.2%) with epinephrine (1:100,000) was administered to the wound intraoperatively along with supplementary postoperative injections via an intraarticular epidural catheter. Oral analgesia was instituted preoperatively with a multimodal regimen (gabapentin, celecoxib, and acetaminophen). Pain was assessed repeatedly for 48 hours postoperatively, at rest and with 45° hip flexion. Results Pain scores were low and similar between ropivacaine and saline administration. Median hospital stay was 4 (range 2-7) days. Interpretation Intraoperative high-volume infiltration with 0.2% ropivacaine with repeated intraarticular injections postoperatively may not give a clinically relevant analgesic effect in THA when combined with a multimodal oral analgesic regimen with gabapentin, celecoxib, and acetaminophen.
OriginalsprogEngelsk
TidsskriftActa Orthopaedica (Print Edition)
Vol/bind82
Udgave nummer4
Sider (fra-til)423-6
Antal sider4
ISSN1745-3674
DOI
StatusUdgivet - 1 aug. 2011

ID: 40169317