Intra-articular local anaesthetic on the day after surgery improves pain and patient satisfaction after Unicompartmental Knee Replacement: a randomised controlled trial.

J S Weston-Simons, H Pandit, V Haliker, C A F Dodd, M T Popat, D W Murray

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, UK. sam.weston-simons@ndorms.ox.ac.uk

The Knee 2012 Aug

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Intra-operative local anaesthetic infiltration provides good early pain relief after Unicompartmental Knee Replacement (UKR). However, appreciable pain may occur on the day after surgery. The purpose of this double-blinded, prospective randomised controlled trial was to evaluate the effectiveness of a bolus of local intra-articular anaesthetic given early on the day after surgery. Forty-four patients were randomised to receive an intra-articular injection, via an epidural catheter inserted at operation, of either 20 ml 0.5% plain bupivacaine or 20 ml normal saline. All patients received a femoral nerve block with 20 ml prilocaine 1% and local anaesthetic infiltration by the surgeon. Patients injected with bupivacaine had significantly less (p<0.001) pain than control patients immediately (mean pain score 1.82 v 6.1) and 6 hours (2.5 v 5.7) after injection. Patient satisfaction was also significantly greater (p<0.001) in the local anaesthetic group. We conclude that a bolus dose of intra-articular bupivacaine early on the day after surgery dramatically improves pain control after UKR and improves patient satisfaction. Copyright © 2011 Elsevier B.V. All rights reserved.

Citation

J S Weston-Simons, H Pandit, V Haliker, C A F Dodd, M T Popat, D W Murray. Intra-articular local anaesthetic on the day after surgery improves pain and patient satisfaction after Unicompartmental Knee Replacement: a randomised controlled trial. The Knee. 2012 Aug;19(4):352-5