Use of reduced-dose periarticular injection for pain management in simultaneous bilateral total knee arthroplasty.
We investigated the safety and efficacy of the bilateral periarticular multimodal drug injection (PMDI) at a reduced dosage in patients undergoing simultaneous bilateral total knee arthroplasty (SBTKA). In total, 45 patients undergoing SBTKA received 65 mL PMDI in each knee (reduced-dose group). The incidence of drug-related adverse effects and wound complications were evaluated. Pain levels during the night of the operation and postoperative day 1 and opioid consumption during the first 24 hours after surgery were compared with the regular-dose group of 55 patients undergoing SBTKA who received 100 mL of PMDI in 1 knee. No patient experienced a serious drug-related adverse effect or wound complication. Blood levels of ropivacaine were observed to be lower than a toxic level throughout the monitored period in all patients examined. Patients in the reduced-dose group experienced less pain during the night of operation, but a similar pain level at postoperative day 1.
Department of Orthopaedic Surgery, Uijeongbu St Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Gyeonggi-do, South Korea.
In Jun
IJ
Koh
Yeon Gwi
YG
Kang
Chong Bum
CB
Chang
Junghan
J
Song
Young-Tae
YT
Jeon
Tae Kyun
TK
Kim
D000368:Aged; D000577:Amides / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage; D016022:Case-Control Studies; D002444:Cefuroxime / Q000008:administration & dosage; D000068579:Celecoxib; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007270:Injections, Intra-Articular / Q000009:adverse effects; D007660:Ketoprofen / Q000008:administration & dosage; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D010098:Oxycodone / Q000008:administration & dosage; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011720:Pyrazoles / Q000008:administration & dosage; D000077212:Ropivacaine; D018709:Statistics, Nonparametric; D013449:Sulfonamides / Q000008:administration & dosage; D016896:Treatment Outcome
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D009020:Morphine; D000077212:Ropivacaine; D007660:Ketoprofen; D010098:Oxycodone; D000068579:Celecoxib; D002444:Cefuroxime; D005283:Fentanyl; D002045:Bupivacaine; D004837:Epinephrine