title: Intra-articular local anaesthetic on the day after surgery improves pain and patient satisfaction after Unicompartmental Knee Replacement: a randomised controlled trial.
abstract: Intra-operative local anaesthetic infiltration provides good early pain relief after Unicompartmental Knee Replacement (UKR). However, appreciable pain may occur on the day after surgery. The purpose of this double-blinded, prospective randomised controlled trial was to evaluate the effectiveness of a bolus of local intra-articular anaesthetic given early on the day after surgery. Forty-four patients were randomised to receive an intra-articular injection, via an epidural catheter inserted at operation, of either 20 ml 0.5% plain bupivacaine or 20 ml normal saline. All patients received a femoral nerve block with 20 ml prilocaine 1% and local anaesthetic infiltration by the surgeon. Patients injected with bupivacaine had significantly less (p<0.001) pain than control patients immediately (mean pain score 1.82 v 6.1) and 6 hours (2.5 v 5.7) after injection. Patient satisfaction was also significantly greater (p<0.001) in the local anaesthetic group. We conclude that a bolus dose of intra-articular bupivacaine early on the day after surgery dramatically improves pain control after UKR and improves patient satisfaction.
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, UK. sam.weston-simons@ndorms.ox.ac.uk
authors.forename: J S
authors.initials: JS
authors.lastname: Weston-Simons
authors.forename: H
authors.initials: H
authors.lastname: Pandit
authors.forename: V
authors.initials: V
authors.lastname: Haliker
authors.forename: C A F
authors.initials: CA
authors.lastname: Dodd
authors.forename: M T
authors.initials: MT
authors.lastname: Popat
authors.forename: D W
authors.initials: DW
authors.lastname: Murray
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D006801:Humans; D007270:Injections, Intra-Articular; D020370:Osteoarthritis, Knee / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine