Articles and commentary regarding the role of local analgesia in total hip and knee arthroplasty: Commentary

摘要

Question: In patients having total knee arthro-plasty, what is the effectiveness of an intra-articular compared with an extra-articular infusion of local anesthetics with use of a local infiltration of analgesia approach at the end of surgery? Design: Randomized (allocation concealed), blinded (patients, investigators, physiotherapists, and postoperative care staff), controlled trial with 3-month follow-up.Setting: The unit for Rheumatic Surgery, Spenshult Hospital, Oskarstrom, Sweden. Patients: 36 patients <80 years of age (mean age, 67 years; 73% women) who were scheduled for total knee arthroplasty because of rheumatoid arthritis. Exclusion criteria were major psychological problems, contraindication to any of the study drugs, renal insufficiency, abnormal liver enzymes, stroke or neurological deficit, angina, severe diabetes, chronic opioid use, or inability to use patient-controlled analgesia. 33 patients (92%) completed the study.