title: Perioperative local infiltration anesthesia with ropivacaine has no effect on postoperative pain after total hip arthroplasty.
abstract: OBJECTIVE
  The local infiltration analgesia (LIA) technique has been widely used to reduce opioid requirements and to improve postoperative mobilization following total hip arthroplasty (THA). However, the evidence for the efficacy of LIA in THA is not yet clear. We determined whether single-shot LIA in addition to a multimodal analgesic regimen would reduce acute postoperative pain and opioid requirements after THA.
  
  
  METHODS
  116 patients undergoing primary THA under spinal anesthesia were included in this randomized, double-blind, placebo-controlled trial. All patients received oral opioid-sparing multimodal analgesia: etoricoxib, acetaminophen, and glucocorticoid. The patients were randomized to receive either 150 mL ropivacaine (2 mg/mL) and 0.5 mL epinephrine (1 mg/mL) or 150 mL 0.9% saline. Rescue analgesic consisted of morphine and oxycodone as needed. The primary endpoint was pain during mobilization in the recovery unit. Secondary endpoints were pain during mobilization on the day after surgery and total postoperative opioid requirements on the first postoperative day.
  
  
  RESULTS
  The levels of pain during mobilization-both in the recovery unit and on the day after surgery-and consumption of opioids on the first postoperative day were similar in the 2 groups.
  
  
  CONCLUSIONS
  LIA did not provide any extra analgesic effect after THA over and above that from the multimodal analgesic regimen used in this study.
authors.affiliation: a 1 Orthopedic Research Center , Department of Orthopaedic Surgery.
authors.forename: Janne Kristin
authors.initials: JK
authors.lastname: Hofstad
authors.affiliation: a 1 Orthopedic Research Center , Department of Orthopaedic Surgery.
authors.forename: Siri B
authors.initials: SB
authors.lastname: Winther
authors.affiliation: b 2 Department of Anesthesiology , Trondheim University Hospital, Trondheim, Norway.
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Rian
authors.affiliation: a 1 Orthopedic Research Center , Department of Orthopaedic Surgery.
authors.forename: Olav A
authors.initials: OA
authors.lastname: Foss
authors.affiliation: a 1 Orthopedic Research Center , Department of Orthopaedic Surgery.
authors.forename: Otto S
authors.initials: OS
authors.lastname: Husby
authors.affiliation: a 1 Orthopedic Research Center , Department of Orthopaedic Surgery.
authors.forename: Tina S
authors.initials: TS
authors.lastname: Wik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000700:Analgesics; D000772:Anesthesia, Local / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care / Q000379:methods; D000077212:Ropivacaine; D055815:Young Adult
chemical_list: D000577:Amides; D000700:Analgesics; D000077212:Ropivacaine