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Postoperative local analgesia infiltration shown to have no effect following THA
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NEW ORLEANS — Intraoperative local infiltration analgesia alone produced the same results for treatment of pain compared with intra- and postoperative local infiltration analgesia in patients undergoing noncemented total hip arthroplasty, according to a study presented at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons, here.
Kirsten Specht, RN, presented the results of the double-blind, randomized clinical trial that included 60 total hip arthroplasty patients.
Specht said that the aim of the study was to investigate the effects of postoperative local infiltration analgesia on pain and opioid consumption during the first 24 postoperative hours.
“It is a recognized problem that opioids, when used in postoperative pain treatment, create troublesome side effects like nausea, vomiting and dizziness,” Specht said.
Study design
Patients were divided into two groups.
“Postoperatively, patients in the intervention group had local infiltration analgesia injected at 10 and 22 hours,” Specht said. “In the placebo group, saline was used.”
Pain levels were managed using the WOMAC and Numerical Ratings Scale, and were assessed with patients at rest and while walking, according to Specht.
Results
Specht reported that no significant difference was observed between the two groups’ pain scores. In addition to having no noticeable effect on pain during the first 24 hours, she also cited the potential for deep infection during catheter placement and delayed mobilization as reasons why postoperative local infiltration analgesia should not be administered.
“Adding local infiltration analgesia postoperatively would not be recommended for patients undergoing noncemented total hip arthroplasty if intraoperative local infiltration analgesia has been used,” she concluded.
- Reference:
Specht K, Leonhardt JS, Revald P, Mandoe H, Andresen EB, Brodersen J, Kjaersgaard-Andersen P. No effect of local infiltration analgesia (LIA) in pain treatment after total hip arthroplasty (THA). Paper 315. Presented at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons. March 9-13. New Orleans.
She has received research or institutional support from Biomet and Stryker.
