Postoperative analgesia in total hip arthroplasty: a randomized double-blinded, placebo-controlled study on peroperative and postoperative ropivacaine, ketorolac, and adrenaline wound infiltration.
BACKGROUND
Comfort and lack of pain are important for optimal mobilization after hip replacement. We investigated the efficacy of double wound infiltration.


METHODS
40 consecutive patients undergoing total hip replacement were randomized into two groups in this double-blinded study. They received wound infiltration at the end of surgery and through an intraarticular catheter 24 h postoperatively. The catheter was placed at the end of surgery. One group received solutions of ropivacaine, ketorolac, and adrenaline. Patients in the control group were injected with saline instead. The observation period was 6 weeks.


RESULTS
The patients who received the analgesic solution had less pain up to 2 weeks postoperatively. They reached an earlier and lower pain minimum during the first days postoperatively, had lower use of analgesia up to day 4 postoperatively, and were more satisfied. Use of analgesic solution resulted in less joint stiffness and better function 1 week postoperatively.


CONCLUSIONS
Operative and postoperative wound infiltration with multimodal drugs reduces pain and the requirement for analgesics after hip replacement, leading to faster postoperative mobilization.
Andersen
Lasse Juel
LJ
Department of Orthopaedic Surgery, Odense University Hospital, Middelfart, Denmark.
Poulsen
Thomas
T
Krogh
Bo
B
Nielsen
Tommy
T
D000577:Amides / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D020910:Ketorolac / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010919:Placebos; D020127:Recovery of Function; D000077212:Ropivacaine; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000577:Amides; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D014662:Vasoconstrictor Agents; D000077212:Ropivacaine; D004837:Epinephrine; D020910:Ketorolac