title: Additional pain relieving effect of intraoperative periarticular injections after simultaneous bilateral TKA: a randomized, controlled study.
abstract: The authors investigated the clinical value of intraoperative periarticular multimodal drug injections (PMDI) in patients on continuous epidural analgesia after simultaneous bilateral TKAs. In 55 patients scheduled to undergo simultaneous bilateral TKAs, one knee was randomly assigned to the PMDI group for which intraoperative periarticular injections were administered and the other knee was assigned to the No-PMDI group for which the injections were not done. These two groups were compared for pain level (during the operation night and on postoperative days (POD) 1, 4, and 7), functional recovery (ability to perform straight leg raising on POD 1 and maximum flexion on POD 7), patient satisfaction (POD 7), and the incidence of wound complications. The PMDI group showed a lower pain level during the operation night and on POD 1 than the No-PMDI group, but no differences in pain levels were observed between the groups on POD 4 or 7. Furthermore, no significant group differences were found in terms of functional recovery, patient satisfaction. No wound complication has been occurred in the PMDI group. This study demonstrates that PMDI provides additional pain relief limited to the immediate postoperative period but does not improve pain relief after POD 1, patient satisfaction and functional recovery.
authors.affiliation: Joint Reconstruction Center, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
authors.forename: In Jun
authors.initials: IJ
authors.lastname: Koh
authors.forename: Yeon Gwi
authors.initials: YG
authors.lastname: Kang
authors.forename: Chong Bum
authors.initials: CB
authors.lastname: Chang
authors.forename: Sae Kwang
authors.initials: SK
authors.lastname: Kwon
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Seo
authors.forename: Sang Cheol
authors.initials: SC
authors.lastname: Seong
authors.forename: Tae Kyun
authors.initials: TK
authors.lastname: Kim
mesh_terms: D000368:Aged; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007267:Injections; D007430:Intraoperative Care / Q000379:methods*; D020910:Ketorolac / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D004338:Drug Combinations; D009020:Morphine; D000077212:Ropivacaine; D020910:Ketorolac