Pain Management in Total Knee Artroplasty: Local Periarticular Injection

Abstract

Objective: Pain that occurs in the early period after total knee arthroplasty (TKA) operation decreases patient comfort and affects rehabilitation. For this reason, various methods are used to reduce pain after surgery. Our aim in this study is to compare the local periarticular injection (LPE) regimen applied during surgery with the classical analgesic regimen. Patients and methods: 124 patients who underwent arthroplasty due to primary gonarthrosis were included in our study. The classical analgesic regimen (oral or iv nsaii / opioid) was performed in 54 patients, and local periarticular injection (intraoperative morphine-diclofenac-adrenaline-bupivacaine cocktail) was performed in 70 patients and compared as a backward cohort. Patients examined for preop and postop 6th Hour, 12th Hour, 24th Hour, 48th Hour, 72th Hour and 15th Day 30th Day visual pain scale (VAS), flexion-extension degree, oral and parenteral drug use, postop bleeding and complications. Those with bilateral TKA, those with chronic liver disease, those with chronic kidney disease, all revision TKAs were not included in the study. Results: There was no statistically significant difference between age, body mass index, length of stay, walker release and blood transfusion values between the two groups (p˃0.05). Postoperative 6th and 12th hours, postoperative 1st and 2nd day VAS scores, hemovac drain bleeding amount, postoperative NSAID, acetaminophen and Opioid use were found to be statistically significantly lower in patients undergoing LPE (p˂0.05). There was no statistically significant difference between the groups in terms of postoperative 3-15-30th Day VAS values (p˃0.05). In addition, the postoperative 1st and 15th flexion values were found to be statistically significantly higher in those who underwent LPE (p˂0.05). There was no significant difference between the two groups in terms of other data and complications. Conclusion: Although the number of drugs in the cocktail we use in our study is low compared to similar studies in the literature, its effectiveness was found similar and significant with other studies. As a result, local periarticular injection is a highly effective and applicable method for early rehabilitation, pain control and bleeding control after total knee arthroplasty.

Keywords: local periarticular enjection, total knee arthroplasty, pain

Special Issue of Health Sciences

DOI: 10.7176/JSTR/6-03-40