title: The efficacy of subcutaneous local analgesic infusion in the early postoperative period after bilateral total knee arthroplasty.
abstract: OBJECTIVE
  This study aims to evaluate the analgesic and functional efficacy of subcutaneous local analgesic infusion (ScLAI) in the early postoperative period (especially on the second postoperative day) in patients undergoing simultaneous bilateral total knee arthroplasty with an intraoperative periarticular injection (PAI) of local analgesic cocktail.
  
  
  METHODS
  Fifteen patients (1 male, 14 females; mean age 62 years; range 52 to 76 years) who underwent simultaneous bilateral total knee arthroplasty (30 knees) and who received the same pre- and intraoperative analgesic protocols were included in this randomized, double-blind, placebo-controlled study. By using a flexible catheter, bupivacaine was administered for ScLAI to either knee (ScLAI group) and placebo infusion was applied to the other one (control group). Postoperative visual analog scale (VAS) pain scores and knee functions were compared between bupivacain and placebo infused knees.
  
  
  RESULTS
  In the ScLAI group, VAS pain scores were lower than the control group during knee flexion and straight leg raise activities (SLR) on the second postoperative day. ScLAI also prevented the rebound pain following intraoperative PAI of local analgesic cocktail and prolonged the analgesic efficacy period of the cocktail during both knee flexion and SLR.
  
  
  CONCLUSIONS
  Subcutaneous infusion of bupivacaine in patients undergoing simultaneous bilateral total knee arthroplasty may prevent emergence of the rebound pain arising after application of intraoperative PAI of local analgesic cocktail and prolong the analgesic efficacy of the cocktail during both knee flexion and SLR activities on the second postoperative day.
authors.affiliation: Department of Orthopedics and Traumatology, Medical Faculty of Afyon Kocatepe University, 03200 Afyonkarahisar, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eroğlu
authors.forename: Mehmet Serhan
authors.initials: MS
authors.lastname: Er
authors.forename: Levent
authors.initials: L
authors.lastname: Altınel
authors.forename: Serdar
authors.initials: S
authors.lastname: Kokulu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yücehan
mesh_terms: D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control; D059035:Perioperative Period / Q000379:methods; D016059:Range of Motion, Articular; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D002045:Bupivacaine