• Guillaume Villatte, Emilien Engels, Roger Erivan, Aurélien Mulliez, Nicolas Caumon, Stéphane Boisgard, and Stéphane Descamps.
• Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France. guillaumevillatte@hotmail.fr.
• Int Orthop. 2016 Nov 1; 40 (11): 2255-2260.

PurposeTotal hip arthroplasty (THA) is considered a painful procedure with significant blood loss. The aim of the this study was to determine whether local infiltration analgaesia (LIA) (with long-acting local anaesthetics and epinephrine) during THA could reduce acute postoperative pain, improve early recovery and reduce per- and postoperative bleeding.MethodsOne hundred and fifty patients scheduled for primary THA were randomised into two groups. The treatment group received LIA (ropivacaine with epinephrine), whereas the control group had no infiltration. Pain intensity was measured with a visual analogue scale (VAS) for the duration of hospital stay and analgaesic consumption. Length of hospital stay, time to get out of bed alone and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index at 3, 6 and 12 months were recorded to evaluate recovery. Per- and postoperative bleeding were evaluated using direct and indirect criteria (operative blood loss, haemoglobin, estimation of uncompensated blood loss and red blood cell transfusion).ResultsPatients with LIA had significantly less pain during the first 24 h (p = 0.04). No significant differences were found in terms of analgaesic consumption (p = 0.57), early and delayed recovery or bleeding between groups.ConclusionsOperative wound infiltration of LIA reduced acute pain after primary THA but did not improve recovery or influence per- and postoperative bleeding.

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