title: No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty.
abstract: OBJECTIVE
  Postoperative analgesia after primary total hip arthroplasty (THA) using opioids is associated with troublesome side effects such as nausea and dizziness, and epidural analgesic means delayed mobilization. Thus, local infiltration analgesia (LIA) during surgery prolonged with local infusion analgesia (LINFA) into the soft tissue in the hip region through a catheter in the first postoperative days has gained major interest in THA fast-track settings within a short period of time. LIA at the time of surgery is a validated treatment. We investigated the additional effect of giving postoperative LINFA after THA in patients already having LIA during surgery.
  
  
  METHODS
  60 consecutive patients undergoing non-cemented THA were randomized into two groups in a double-blind and controlled study. During surgery, all patients received standardized pain treatment with LIA. Postoperatively, they were treated either with a solution of Ropivacain, Ketorolac, and Adrenaline (LINFA group) or placebo (placebo group) administered through a catheter to the hip 10 and 22 h after surgery. Pain score, opioid consumption, and length of stay (LOS) were evaluated.
  
  
  RESULTS
  After adjustment for multiple testing, there was no statistically significant postoperative difference between the LINFA group and the placebo group regarding pain and tiredness. We found some evidence of a short-term effect on nausea and vomiting. Opioid consumption and length of stay were similar in the two groups.
  
  
  CONCLUSIONS
  We found some evidence of a short-term effect of LINFA on nausea and vomiting, but no evidence of an effect on postoperative pain and tiredness. Thus, LINFA cannot be recommended as a standard pain treatment in patients with THA.
authors: Clinical Research Unit, Department of Orthopaedics, Vejle Hospital, Denmark. kirsten.specht@slb.regionsyddanmark.dk
authors: Kirsten
authors: K
authors: Specht
authors: Jane Schwartz
authors: JS
authors: Leonhardt
authors: Peter
authors: P
authors: Revald
authors: Hans
authors: H
authors: Mandøe
authors: Else Bay
authors: EB
authors: Andresen
authors: John
authors: J
authors: Brodersen
authors: Svend
authors: S
authors: Kreiner
authors: Per
authors: P
authors: Kjaersgaard-Andersen
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