Efficacy of periarticular injection of bupivacaine, fentanyl, and methylprednisolone in total knee arthroplasty:a prospective, randomized trial.
We evaluated the efficacy of periarticular infiltration of corticosteroid, opioid, and a local anesthetic by comparing pain scores, knee flexion, and quadriceps function on the day of surgery, first postoperative day, day of discharge, and 2 and 4 weeks after surgery between the infiltrated and the noninfiltrated knee in 40 patients undergoing simultaneous bilateral computer-assisted total knee arthroplasty who were randomized to receive the injection in the right or left knee. In comparison to the noninfiltrated side, the infiltrated knee showed significantly lower pain scores, significantly greater active flexion up to 4 weeks, and superior quadriceps recovery up to 2 weeks after surgery. This simple and inexpensive technique can significantly reduce pain and hasten functional recovery in the first month after total knee arthroplasty.
Mullaji
Arun
A
Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India.
Kanna
Raj
R
Shetty
Gautam M
GM
Chavda
Vipul
V
Singh
D P
DP
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D016059:Range of Motion, Articular; D025321:Surgery, Computer-Assisted
D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D005938:Glucocorticoids; D005283:Fentanyl; D008775:Methylprednisolone; D002045:Bupivacaine