Chinese Journal of Tissue Engineering Research ›› 2014, Vol. 18 ›› Issue (4): 529-534.doi: 10.3969/j.issn.2095-4344.2014.04.007

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Continuous analgesia of local infiltration after total knee arthroplasty

Lu Hui-hong1, Li Gui-feng1, Bai Lang1, Sun Ji-xiong1, Jiang Zhen1, Yin Feng2   

  1. 1Department of Anesthesiology, Shanghai East Hospital, Shanghai Tongji University, Shanghai 200120, China; 2Department of Orthopaedic Surgery, Shanghai East Hospital, Shanghai Tongji University, Shanghai 200120, China
  • Revised:2013-11-11 Online:2014-01-22 Published:2014-01-22
  • Contact: Li Gui-feng, Attending physician, Department of Anesthesiology, Shanghai East Hospital, Shanghai Tongji University, Shanghai 200120, China
  • About author:Lu Hui-hong, Master, Attending physician, Department of Anesthesiology, Shanghai East Hospital, Shanghai Tongji University, Shanghai 200120, China

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Abstract:

 BACKGROUND: Accumulating studies have confirmed the excellent effectiveness of local infiltration analgesia, but the literature analysis is mainly limited to within 1 day after total knee arthroplasty or shorter period.

OBJECTIVE: To study the effectiveness of local infiltration analgesia (LIA) at low concentration after total knee arthroplasty, and to observe the analgesic effect at rest and movement states.
METHODS: Thirty patients undergoing total knee arthroplasty were randomly allocated to control group and LIA group, receiving oral non-steroidal antiinflammatory drug (celebrex) and low concentration of ropivacaine (0.1%) for epidural analgesia. Control group was injected with 0.9% saline 150 mL, while LIA group was injected with equal volume of solution include ropivacaine 300 mg, morphine 5 mg and epinephrine 10 μg. The rest pain and motion pain of patients in two groups were evaluated at 6, 12, 24, 36, 48 hours after operation by using visual analogue scale. The incidence rate and degree of nausea, vomiting, numbness and muscle weakness of the legs were observed after operation. The incision healing was also recorded.

RESULTS AND CONCLUSION: Visual analogue scale pain scores in the LIA group were significantly lower than the control group at 6, 12, 24 and 36 hours at rest (P < 0.05), at 6, 12, 24, 36, 48 hours on movement (P < 0.05). At 6 and   12 hours, there was no difference in the rest and motion pains in the LIA groups (P > 0.05). No patient appeared drowsiness, nausea, and vomiting in both groups. Two patients in each group complained of slight numbness in legs. No case influenced function exercise because of muscle weakness. All the wounds healed and there were no incision infections in two groups. Combined with oral non-steroidal anti-inflammatory drug and low concentration of ropivacaine for epidural analgesia, the local infiltration analgesia technique in total knee arthroplasty is effective in early post-operative pain management, and produces no analgesia related adverse reactions.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


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Key words: arthroplasty, replacement, knee, analgesia, analgesia, epidural, anti-inflammatory drug, non-steroidal

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