Abstract | PURPOSE: METHODS: Fifty 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. RESULTS: VAS 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. CONCLUSION: To 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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Authors | Martijn G M Schotanus, Yoeri F L Bemelmans, P Hugo M van der Kuy, Jacqueline Jansen, Nanne P Kort |
Journal | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
(Knee Surg Sports Traumatol Arthrosc)
Vol. 25
Issue 9
Pg. 2778-2783
(Sep 2017)
ISSN: 1433-7347 [Electronic] Germany |
PMID | 26210962
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Amides
- Anesthetics, Local
- Ropivacaine
- Epinephrine
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Topics |
- Aged
- Amides
(therapeutic use)
- Analgesia
(methods)
- Anesthetics, Local
(therapeutic use)
- Arthroplasty, Replacement, Knee
- Double-Blind Method
- Drug Therapy, Combination
- Epinephrine
(therapeutic use)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Pain Measurement
- Pain, Postoperative
(diagnosis, prevention & control)
- Patient Reported Outcome Measures
- Perioperative Care
(methods)
- Pilot Projects
- Prospective Studies
- Ropivacaine
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