Acta orthopaedica
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Randomized Controlled Trial
Postoperative analgesia in total hip arthroplasty: a randomized double-blinded, placebo-controlled study on peroperative and postoperative ropivacaine, ketorolac, and adrenaline wound infiltration.
Comfort and lack of pain are important for optimal mobilization after hip replacement. We investigated the efficacy of double wound infiltration. ⋯ Operative and postoperative wound infiltration with multimodal drugs reduces pain and the requirement for analgesics after hip replacement, leading to faster postoperative mobilization.
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Randomized Controlled Trial Comparative Study
Comparison of peri- and intraarticular analgesia with femoral nerve block after total knee arthroplasty: a randomized clinical trial.
Postoperative pain after total knee arthroplasty (TKA) can be difficult to manage and may delay recovery. Recent studies have suggested that periarticular infiltration with local anesthetics may improve outcome. ⋯ Peri- and intraarticular application of analgesics by infiltration and bolus injections can improve early analgesia and mobilization for patients undergoing TKA. Further studies of optimal drugs, dosage, and duration of this treatment are warranted.
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Randomized Controlled Trial Comparative Study
Reduced hospital stay and narcotic consumption, and improved mobilization with local and intraarticular infiltration after hip arthroplasty: a randomized clinical trial of an intraarticular technique versus epidural infusion in 80 patients.
Epidural analgesia gives excellent pain relief but is associated with substantial side effects. We compared wound infiltration combined with intraarticular injection of local anesthetics for pain relief after total hip arthroplasty (THA) with the well-established practice of epidural infusion. ⋯ Wound infiltration combined with 1 intraarticular injection can be recommended for patients undergoing THA. Further studies of dosage (high/low) and duration of intraarticular treatment are warranted.
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For endoprosthetic knee surgery, intensive postoperative pain therapy is necessary. We therefore evaluated whether the combination of continuous psoas compartment and sciatic analgesia (PSC) is as effective as epidural analgesia (EPI) and whether it provides better analgesia than patient-controlled intravenous analgesia with piritramide (PCA). ⋯ Analgesia with PSC catheters or EPI catheter is superior to PCA regarding pain levels, analgesic requirements, and patient satisfaction. There was no difference in functional outcome between the 3 groups.
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The selection of presentations at orthopedic meetings is an important process. If the peer reviewers do not consistently agree on the quality score, the review process is arbitrary and open to bias. The aim of this study was: (1) to describe the inter-reviewer agreement of a previously designed scoring scheme to rate abstracts submitted for presentation at meetings arranged by the Dutch Orthopedic Association; (2) to test whether the quality of reporting of submitted abstracts increased in the years after the introduction of the scoring scheme; and (3) to examine whether a review process with a larger workload had lower interrater agreement. ⋯ The ISK abstract rating system has an excellent interobserver agreement. Other scientific orthopedic meetings should consider adopting this ISK rating system for further evaluation in a local or international setting.