Intra-articular local anaesthetic on the day after surgery improves pain and patient satisfaction after Unicompartmental Knee Replacement: A randomised controlled trial

• Published in: The knee Vol. 19; no. 4; pp. 352 - 355
• Main Authors: Weston-Simons, J.S, Pandit, H, Haliker, V, Dodd, C.A.F, Popat, M.T, Murray, D.W
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.08.2012; Elsevier Limited
• Subjects: Anesthesia; Anesthetics, Local - administration & dosage; Arthroplasty, Replacement, Knee; Bupivacaine; Bupivacaine - administration & dosage; Double-Blind Method; Hospitals; Humans; Injections, Intra-Articular; Intra-articular analgesia; Orthopedics; Osteoarthritis, Knee - surgery; Pain management; Pain, Postoperative - prevention & control; Patient outcome; Patient Satisfaction; Unicompartmental Knee Replacement; Unicompartmental Knee Replacement; Bupivacaine; Patient outcome; Intra-articular analgesia
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2011.04.010

Abstract Intra-operative local anaesthetic infiltration provides good early pain relief after Unicompartmental Knee Replacement (UKR). However, appreciable pain may occur on the day after surgery. The purpose of this double-blinded, prospective randomised controlled trial was to evaluate the effectiveness of a bolus of local intra-articular anaesthetic given early on the day after surgery. Forty-four patients were randomised to receive an intra-articular injection, via an epidural catheter inserted at operation, of either 20 ml 0.5% plain bupivacaine or 20 ml normal saline. All patients received a femoral nerve block with 20 ml prilocaine 1% and local anaesthetic infiltration by the surgeon. Patients injected with bupivacaine had significantly less (p < 0.001) pain than control patients immediately (mean pain score 1.82 v 6.1) and 6 hours (2.5 v 5.7) after injection. Patient satisfaction was also significantly greater (p < 0.001) in the local anaesthetic group. We conclude that a bolus dose of intra-articular bupivacaine early on the day after surgery dramatically improves pain control after UKR and improves patient satisfaction.