Abstract:

BACKGROUND: To ease the pain after total knee arthroplasty (TKA), intravenous catheter analgesia pumps, oral or intravenous pain medications are clinically used currently, which can reduce the pain of patients to some extent. However, intravenous analgesia pump and oral drugs have many side effects, such as affecting the functional exercise patients after the operation and increasing the incidence of complications.

OBJECTIVE: To investigate the efficacy and security of the local application of bupivacaine for pain after TKA.

METHODS: From November 1^st, 2008 to December 31^st, 2009, 168 patients (218 knees) undergoing TKA were selected from Department of Joint Surgery, Provincial Hospital Affiliated to Shandong University. Patients of the intervention group were injected with opite drugs (0.75%bupivacaine 10 mL+epinephrine 0.1 mg+saline 20 mL) in the surgical field around the knee. The control group did not use the anesthesia drug in the local area. Both groups used the intravenous analgesia pump for 50 hours. Visual analog scores and hospital for special surgery knee score for pain were recorded.

RESULTS AND CONCLUSION: Patients in the control group had higher visual analog scores for pain at rest and activity at hours 4, 8 and 12 postoperatively compared with the intervention group (P < 0.05). Three months after TKA, no significant difference was found for special surgery knee scores for pain between two groups (P > 0.05). Four patients in the intervention group took the tramadol sustained-release tablets after the operation, while there were eleven in the control group; sixteen patients in the intervention group could endure the pain with intravenous catheter analgesia pumps only, but only 9 patients in the control group (P < 0.05). In conclusion, intraoperative periarticular injection of bupivacaine in TKA can reduce the pain and improve range of motion at early time, but the injection had no adverse effect on TKA in a short term period.