High-volume infiltration analgesia in bilateral hip arthroplasty

Lasse Ø Andersen, Niels Kristian Stahl Otte, Henrik Husted, Lissi Gaarn-Larsen, Billy Kristensen, Henrik Kehlet

    43 Citations (Scopus)

    Abstract

    Background and purpose High-volume infiltration analgesia may be effective in postoperative pain management after hip arthroplasty but methodological problems prevent exact interpretation of previous studies. Methods In a randomized, double-blind placebo-controlled trial in 12 patients undergoing bilateral total hip arthroplasty (THA) in a fast-track setting, saline or high-volume (170 mL) ropivacaine (0.2%) with epinephrine (1:100,000) was administered to the wound intraoperatively along with supplementary postoperative injections via an intraarticular epidural catheter. Oral analgesia was instituted preoperatively with a multimodal regimen (gabapentin, celecoxib, and acetaminophen). Pain was assessed repeatedly for 48 hours postoperatively, at rest and with 45° hip flexion. Results Pain scores were low and similar between ropivacaine and saline administration. Median hospital stay was 4 (range 2-7) days. Interpretation Intraoperative high-volume infiltration with 0.2% ropivacaine with repeated intraarticular injections postoperatively may not give a clinically relevant analgesic effect in THA when combined with a multimodal oral analgesic regimen with gabapentin, celecoxib, and acetaminophen.
    Original languageEnglish
    JournalActa Orthopaedica (Print Edition)
    Volume82
    Issue number4
    Pages (from-to)423-6
    Number of pages4
    ISSN1745-3674
    DOIs
    Publication statusPublished - 1 Aug 2011

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