Document Detail

Continuous infiltration of local anaesthetic following total knee arthroplasty.
MedLine Citation:
PMID:  20808013     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine whether continuous infiltration of local anaesthetic can reduce the pain score and morphine use over 48 hours after total knee arthroplasty (TKA).
METHODS: 11 men and 43 women aged 50 to 82 years who underwent unilateral TKA for osteoarthritis were recruited. They were randomised into 3 groups. In group 1, 17 patients who acted as controls received patient-controlled analgesia (PCA) with intravenous morphine for 48 hours. In group 2, 16 patients received continuous infiltration of bupivacaine to the subcutaneous tissue and intra-articular space for 48 hours, in addition to PCA. In group 3, 21 patients received an intra-articular injection of local anaesthetic, followed by continuous infiltration of bupivacaine to the subcutaneous tissue and intraarticular space for 48 hours, in addition to PCA. For each patient, a visual analogue score (VAS) for pain was recorded postoperatively at 2, 4, 6, 12, 24, 36, and 48 hours. The total amount of morphine used was recorded at 24 and 48 hours.
RESULTS: Over 48 hours, the VAS for pain and morphine use was significantly higher in controls than patients in groups 2 and 3.
CONCLUSION: Continuous infiltration of local anaesthetic into the intra-articular space and subcutaneous tissues, in addition to PCA with intravenous morphine, provides significantly more pain relief and reduces morphine use.
Johnny C A Ong; Pak Lin Chin; Chin Pak Lin; Stephanie M C Fook-Chong; Andrew Tang; Kuang Ying Yang; Yang Kuang Ying; Boon Keng Tay; Tay Boon Keng
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of orthopaedic surgery (Hong Kong)     Volume:  18     ISSN:  1022-5536     ISO Abbreviation:  J Orthop Surg (Hong Kong)     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-01-25     Revised Date:  2011-09-20    
Medline Journal Info:
Nlm Unique ID:  9440382     Medline TA:  J Orthop Surg (Hong Kong)     Country:  China    
Other Details:
Languages:  eng     Pagination:  203-7     Citation Subset:  IM    
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
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MeSH Terms
Aged, 80 and over
Anesthesia, Local / methods*
Anesthetics, Local / administration & dosage*
Arthroplasty, Replacement, Knee*
Bupivacaine / administration & dosage*
Follow-Up Studies
Injections, Intra-Articular
Injections, Subcutaneous
Middle Aged
Pain Measurement
Pain, Postoperative / diagnosis,  therapy*
Treatment Outcome
Reg. No./Substance:
0/Anesthetics, Local; 2180-92-9/Bupivacaine
Comment In:
J Orthop Surg (Hong Kong). 2010 Dec;18(3):394; author reply 394   [PMID:  21187563 ]
Erratum In:
J Orthop Surg (Hong Kong). 2010 Dec;18(3):395
Note: Lin, Chin Pak [corrected to Chin, Pak Lin]; Ying, Yang Kuang [corrected to Yang, Kuang Ying]; Keng, Tay Boon [corrected to Tay, Boon Keng]

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