title: Single periarticular local infiltration analgesia reduces opiate consumption until 48 hours after total knee arthroplasty. A randomized placebo-controlled trial involving 56 patients.
abstract: BACKGROUND
  Randomized trials evaluating efficacy of local infiltration analgesia (LIA) have been published but many of these lack standardized analgesics. There is a paucity of reports on the effects of LIA on functional capability and quality of life.
  
  
  METHODS
  56 patients undergoing unilateral total knee arthroplasty (TKA) were randomized into 2 groups in this placebo-controlled study with 12-month follow-up. In the LIA group, a mixture of levobupivacaine (150 mg), ketorolac (30 mg), and adrenaline (0.5 mg) was infiltrated periarticularly. In the placebo group, infiltration contained saline. 4 different patient-reported outcome measures (PROMs) were used for evaluation of functional outcome and quality of life.
  
  
  RESULTS
  During the first 48 hours postoperatively, patients in the LIA group used less oxycodone than patients in the placebo group in both cumulative and time-interval follow-up. The effect was most significant during the first 6 postoperative hours. The PROMs were similar between the groups during the 1-year follow-up.
  
  
  CONCLUSIONS
  Single periarticular infiltration reduced the amount of oxycodone used and enabled adequate pain management in conjunction with standardized peroral medication without adverse effects. No clinically marked effects on the functional outcome after TKA were detected.
authors.affiliation: COXA Hospital for Joint Replacement , Tampere , Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Niemeläinen
authors.forename: Jarkko
authors.initials: J
authors.lastname: Kalliovalkama
authors.forename: Antti J
authors.initials: AJ
authors.lastname: Aho
authors.forename: Teemu
authors.initials: T
authors.lastname: Moilanen
authors.forename: Antti
authors.initials: A
authors.lastname: Eskelinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D020910:Ketorolac / Q000008:administration & dosage*; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D010098:Oxycodone / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy*; D010919:Placebos; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D014662:Vasoconstrictor Agents; D000077554:Levobupivacaine; D010098:Oxycodone; D002045:Bupivacaine; D004837:Epinephrine; D020910:Ketorolac