The authors investigated the clinical value of intraoperative periarticular multimodal drug
injections (PMDI) in patients on continuous
epidural analgesia after simultaneous bilateral TKAs. In 55 patients scheduled to undergo simultaneous bilateral TKAs, one knee was randomly assigned to the PMDI group for which intraoperative periarticular
injections were administered and the other knee was assigned to the No-PMDI group for which the
injections were not done. These two groups were compared for
pain level (during the operation night and on postoperative days (POD) 1, 4, and 7), functional recovery (ability to perform straight leg raising on POD 1 and maximum flexion on POD 7), patient satisfaction (POD 7), and the incidence of
wound complications. The PMDI group showed a lower
pain level during the operation night and on POD 1 than the No-PMDI group, but no differences in
pain levels were observed between the groups on POD 4 or 7. Furthermore, no significant group differences were found in terms of functional recovery, patient satisfaction. No
wound complication has been occurred in the PMDI group. This study demonstrates that PMDI provides additional
pain relief limited to the immediate postoperative period but does not improve
pain relief after POD 1, patient satisfaction and functional recovery.