title: High-volume infiltration analgesia in total knee arthroplasty: a randomized, double-blind, placebo-controlled trial.
abstract: BACKGROUND
  High-volume infiltration analgesia may be effective with a low risk of side effects in hip and knee arthroplasty. The present placebo-controlled study was carried out to evaluate the analgesic effect of high-volume infiltration analgesia in bilateral total knee arthroplasty, along with a detailed description of the infiltration technique.
  
  
  METHODS
  In a randomized, double-blind, placebo-controlled trial in 12 patients undergoing bilateral knee arthroplasty, saline or high-volume (170 ml) ropivacaine (0.2%) with epinephrine was infiltrated around each knee, with repeated doses administered through an intra-articular catheter for 24 h and pain and opioid requirements assessed for 48 h in a fast-track setting.
  
  
  RESULTS
  Pain at rest and during movement was significantly reduced for up to 32 h with the high-volume local anesthetic infiltration technique. No major side effects were observed. The median hospital stay was 4 days.
  
  
  CONCLUSIONS
  High-volume infiltration analgesia is effective in knee arthroplasty and, due to its simplicity, may be preferable compared with other analgesic techniques in knee arthroplasty.
authors.affiliation: Department of Anesthesiology, Hvidovre University Hospital, Copenhagen, Denmark. lasse.oestergaard.andersen@hvh.regionh.dk
authors.forename: L Ø
authors.initials: LØ
authors.lastname: Andersen
authors.forename: H
authors.initials: H
authors.lastname: Husted
authors.forename: K S
authors.initials: KS
authors.lastname: Otte
authors.forename: B B
authors.initials: BB
authors.lastname: Kristensen
authors.forename: H
authors.initials: H
authors.lastname: Kehlet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D000077212:Ropivacaine; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D012965:Sodium Chloride; D000077212:Ropivacaine