The journal of knee surgery
-
Randomized Controlled Trial Clinical Trial
Continuous intra-articular infusion of bupivacaine for postoperative pain following total knee arthroplasty.
This study assessed the efficacy of local, continuous infusion of bupivacaine for pain control following total knee arthroplasty. Eleven men and 19 women with an average age of 65 years (range: 43-83 years) randomly received either 0.25% bupivacaine or normal saline by local infusion pump. Standard wound drainage also was implemented. ⋯ Drug lost to drainage was estimated to be 27%. These findings suggest continuous local analgesic infusion after total knee arthroplasty does not offer significant improvements in either pain relief or medication use. Drug loss from drainage may exceed 25% and may compromise analgesic effectiveness.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Bedside femoral block performed on the first postoperative day after unilateral total knee arthroplasty: a randomized study of 49 patients.
This randomized study compared the effectiveness of a femoral nerve block with other methods of pain control on the first postoperative day after total knee arthroplasty. The femoral block consisted of a single injection administered at patients' bedside during the surgeon's hospital rounds. Compared with control group patients, femoral block patients reported less pain on a visual analog scale and required one half the amount of oxycodone (P = .021). ⋯ Thus, pain management with femoral blocks resulted in less work for nursing staff (P = .004). Performing a femoral nerve block as needed during the surgeon's hospital rounds is quick and requires minimal additional time without any special equipment. Bedside femoral block is a useful adjunct to other pain control methods following primary total knee arthroplasty.