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Periarticular injection associated with better pain relief 24 hours after TKA
During the first 24 hours following simultaneous bilateral total knee arthroplasty, periarticular injection was associated with better pain relief and decreased opioid-related side effects compared with epidural analgesia, according to study results.
Researchers randomly assigned 71 patients undergoing total knee arthroplasty (TKA) to receive periarticular injection or epidural analgesia. All patients received identical perioperative interventions, including spinal anesthesia, surgical techniques and postoperative medication protocols. During the initial 24-hour postoperative period, the researchers measured postoperative pain at rest with the use of a 100-mm VAS. The researchers also used the area under the curve to calculate the cumulative VAS, which was compared between the two groups.
Results showed significantly less postoperative pain at rest from 4 to 24 hours postoperatively in patients who received periarticular injection vs. patients who received epidural analgesia. Patients in the periarticular injection group had a significantly lower number of diclofenac sodium suppository administrations used as rescue analgesia on the night of surgery, as well as a significantly lower prevalence of nausea on the night of surgery and postoperative day 1 and of pruritus vs. patients in the epidural analgesia group, according to the researchers.
The researchers also found a significantly better range of flexion in the periarticular injection group during the first 5 days after surgery. However, patients in the epidural analgesia group had better extension at postoperative day 1. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.