title: Analgesic control after hip arthroscopy: a randomised, double-blinded trial comparing portal with intra-articular infiltration of bupivacaine.
abstract: The optimum anaesthetic and analgesic management following hip arthroscopy is yet to be determined. There is, in addition, some concern over the use of intraarticular local anaesthetic. We compared the analgesic efficacy of intra-articular infiltration compared with portal infiltration of bupivacaine following hip arthroscopy. Patients were randomised to receive either 10 ml of 0.25% bupivacaine either into the joint or around the portal sites following completion of surgery. 73 patients were recruited (40 intra-articular). The portal infiltration group required significantly more rescue analgesia immediately after surgery (2.33 mg vs.0.57 mg, p=0.036). Visual Analogue Scale pain scores were not significantly different at 1 and 2 hours following surgery, but at 6 hours the portal group had significantly lower VAS scores (p=0.0036). We believe that the initial pain following surgery results from capsular injury and this explains the need for more rescue analgesia in the portal infiltration group. Further work is needed to establish the ideal regimen. A combination of portal and intra-articular infiltration may be the most efficacious.
authors.affiliation: Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin - Ireland.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Baker
authors.forename: Ciara M
authors.initials: CM
authors.lastname: McGuire
authors.forename: Damien P
authors.initials: DP
authors.lastname: Byrne
authors.forename: Kim
authors.initials: K
authors.lastname: Hunter
authors.forename: Nick
authors.initials: N
authors.lastname: Eustace
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Mulhall
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001182:Arthroscopy / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006621:Hip Joint; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D002045:Bupivacaine