e-book Local Infiltration Analgesia: A Technique to Improve Outcomes after Hip, Knee or Lumbar Spine Surgery

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Several studies described the continuous LIA in order to prolong its effect by use of e. The results are varying: In a randomized double-blind study, Ali et al. However, a higher risk of wound-healing complications including deep infections was described [ 48 , 49 ]. In another study comparing single-injection and continuous LIA, continuous infiltration resulted in prolonged superior analgesia and was associated with better functional recovery and patient satisfaction [ 50 ]. In terms of accelerated chondrotoxicity and risk for infection after prolonged exposure, we recommend avoiding using continuous infiltration or even additional single shots after some hours.

There are some limitations that pertain to that study. Due to its retrospective design, the study was not blinded or randomized, which may have introduced reporting bias. Furthermore, the choice of anesthesia by the patient might have induced some selection bias, although the group characteristics appeared to be identical among the four groups. Although it was a retrospective investigation, the strengths of the study include a large number of patients managed according to clear inclusion and exclusion criteria. The surgical and anesthetic procedures followed a consistent standard-treatment protocol in the same hospital by the same surgeons with extensive surgical experience in the treatment of UKA and its concomitant analgesic procedures.

In conclusion, the findings from this study suggest a slight but clinically not relevant advantage of the LIA groups in the early postoperative period in terms of mobilization, muscle strength and range of motion. In general, pain relief was similar in all groups, with exception of a significant lower NRS score at rest in the LIA groups at day of surgery.

Pain Management After Total Hip Replacement

Preoperative information including knee function and pain status should be considered for each patient individually before choosing a multimodal perioperative analgesia protocol. In UKA, infiltration of a local anesthetic offers a safe and effective treatment option comparable to the well-established conventional procedures.

RFA - Radiofrequency Ablation

The authors thank the research assistants Steffen Klingbeil and Dr. PA helped with the statistical analysis of the data. WR and VB supervised the whole study and helped to finalize the manuscript. All authors read and approved the final manuscript. This study adhered to the tenets of the Helsinki Declaration and its later amendments. Written consent was obtained from all participants for the surgical and anesthetic procedures; further consent for retrospective analysis of the data was waived by the Ethics Committee of the Bavarian State Chamber of Physicians ID: — Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Friederichs, Email: ed. Leidinger, Email: ed. Augat, Email: ed. Fulghum, Email: ed. Reng, Email: ed. National Center for Biotechnology Information , U. BMC Musculoskelet Disord. Published online Jul Berninger , 1, 2 J. Friederichs , 2 W. Leidinger , 3 P. Augat , 4, 5 V.


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Fulghum , 1 and W. Reng 1. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Jan 3; Accepted Jul 2. Abstract Background The aim of the study was to analyze the effect of local infiltration analgesia LIA , peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary unicompartmental knee arthroplasty UKA. Keywords: Local infiltration analgesia, Femoral nerve block, Unicompartmental knee arthroplasty, Epidural catheter, General anesthesia, Spinal anesthesia. Background Anteromedial knee osteoarthritis is a distinct clinicopathological entity which often leads to disabling pain and limitation of range of motion [ 1 ].

Methods Patients One hundred thirty four patients were treated for medial knee osteoarthritis with UKA between January and August and were included for this retrospective analysis. Table 1 Patients demographics and clinical data. Open in a separate window. Surgery All surgeries were performed by three senior surgeons. Postoperative pain management and care Postoperative management was identical in all groups. Mobilization Upon analyzing the grade of mobilization, no significant differences among the groups at any time point were observed Fig.

Range of motion The mean range of motion flexion and extension of the knee joint was similar within the groups Fig. Conclusions In conclusion, the findings from this study suggest a slight but clinically not relevant advantage of the LIA groups in the early postoperative period in terms of mobilization, muscle strength and range of motion. Acknowledgments The authors thank the research assistants Steffen Klingbeil and Dr. Notes Ethics approval and consent to participate This study adhered to the tenets of the Helsinki Declaration and its later amendments.

Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Contributor Information M. References 1. Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of cases. Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res.

Patient-perceived outcomes and return to sport and work: TKA versus mini-incision unicompartmental knee arthroplasty. J Knee Surg. Adverse outcomes after total and unicompartmental knee replacement in , matched patients: a study of data from the National Joint Registry for England and Wales.

Minimally invasive surgical technique for unicondylar knee arthroplasty. J South Orthop Assoc. Minimally invasive knee arthroplasty: an overview. World J Orthop. Femoral nerve blocks for acute postoperative pain after knee replacement surgery. Cochrane Database Syst Rev. The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty.

Anesth Analg. Postoperative falls after total knee arthroplasty in patients with a femoral nerve catheter: can we reduce the incidence? J Arthroplast. Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of patients. Acta Orthop. Femoral nerve block versus long-acting wound infiltration in Total knee arthroplasty. The analgesic efficacy of local infiltration analgesia vs femoral nerve block after total knee arthroplasty: a systematic review and meta-analysis.

Br J Anaesth. The technique of delivery of peri-operative analgesia does not affect the rehabilitation or outcomes following total knee arthroplasty. Bone Joint J. Local infiltration analgesia versus femoral nerve block in total knee arthroplasty: a meta-analysis. Orthop Traumatol Surg Res. Pain Management for Total Knee Arthroplasty: single-injection femoral nerve block versus local infiltration analgesia. Iran Red Crescent Med J. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty.

A comparison of epidural analgesia and local infiltration analgesia methods in pain control following total knee arthroplasty. Acta Orthop Traumatol Turc. Accelerated recovery for unicompartmental knee replacement--a feasibility study. Efficacy of an accelerated recovery protocol for Oxford unicompartmental knee arthroplasty--a randomised controlled trial. Reduced hospital stay, morphine consumption, and pain intensity with local infiltration analgesia after unicompartmental knee arthroplasty.

Analgesic efficacy of subcutaneous local anaesthetic wound infiltration in bilateral knee arthroplasty: a randomised, placebo-controlled, double-blind trial. Acta Anaesthesiol Scand.

Pain Management After Total Hip Replacement | SpringerLink

Single periarticular local infiltration analgesia reduces opiate consumption until 48 hours after total knee arthroplasty. A randomized placebo-controlled trial involving 56 patients. Opioid complications and side effects. Pain Physician. Early recovery after fast-track Oxford unicompartmental knee arthroplasty. Effect of periarticular corticosteroid injections during total knee arthroplasty. A double-blind randomized trial. J Bone Joint Surg Am. Is intra-articular multimodal drug injection effective in pain management after total knee arthroplasty?

A randomized, double-blinded, prospective study. J Arthroplasty. Peri-articular steroid injection improves the outcome after unicondylar knee replacement: a prospective, randomised controlled trial with a two-year follow-up. Effects of periarticular steroid injection on knee function and the inflammatory response following Unicondylar knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc. McCarthy D, Iohom G. Local infiltration analgesia for postoperative pain control following Total hip arthroplasty: a systematic review. Anesthesiol Res Pract. Pharmacokinetics of mg ropivacaine after periarticular local infiltration analgesia for total knee arthroplasty. Single-dose local anesthetics exhibit a type-, dose-, and time-dependent chondrotoxic effect on chondrocytes and cartilage: a systematic review of the current literature.

Local anesthetic cytotoxicity on human mesenchymal stem cells during chondrogenic differentiation. Cost analysis should also be looked at. International Scholarly Research Notices. Table of Contents. Journal Menu. Abstract The last 10 years has seen the increased use of enhanced recovery pathways across several surgical specialities. Table 2: Overview of the literature summarising study outcome measures, results, and conclusions. References H. Kehlet and D. Husted and G. S31—S35, O'Brien, L. Ogonda, S. Dennison et al. Basse, D. Jakobsen, P. Werner, and H. Maheshwari, Y.

Blum, L. Shekhar, A. Ranawat, and C. Rodgers, N. Walker, S. Schug et al. Urwin, M. Parker, and R. Rasmussen, T.


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