Acta orthopaedica Scandinavica
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Clinical Trial Controlled Clinical Trial
Increased flexion and reduced hospital stay with continuous intraarticular morphine and ropivacaine after primary total knee replacement: open intervention study of efficacy and safety in 154 patients.
A single injection of bupivacaine after wound closure reduces the need for analgesics and increases flexion after total knee replacement (TKR). We have therefore studied the effect of continuous injection of morphine and ropivacaine after TKR on range of movement and length of hospital stay. ⋯ Continuous intraarticular morphine and ropivacaine reduce pain and enhance rehabilitation after total knee replacement. Before advocating this as a standard procedure, further large-scale randomized studies will be needed to assess the safety of this regimen.
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A maximum surgical blood ordering schedule may lead to wastage of valuable resources due to over-ordering of blood and/or under-utilisation. We audited the results of a group-and-save (GS) policy for primary hip (THR) and knee (TKR) arthroplasty to evaluate its safety and practicality. ⋯ For routine primary THR/TKR, GS policy is a safe procedure. Reduction in non-utilisation of blood has economic and cost-saving implications for limited healthcare resources. Having subsequently introduced a group-and-save policy for all patients undergoing routine THR/TKR, considerable savings have been identified after only 2 months.