title: Effect of local anaesthetic wound infiltration on acute pain and bleeding after primary total hip arthroplasty: the EDIPO randomised controlled study.
abstract: Total hip arthroplasty (THA) is considered a painful procedure with significant blood loss. The aim of the this study was to determine whether local infiltration analgaesia (LIA) (with long-acting local anaesthetics and epinephrine) during THA could reduce acute postoperative pain, improve early recovery and reduce per- and postoperative bleeding.
  
  
  
  One hundred and fifty patients scheduled for primary THA were randomised into two groups. The treatment group received LIA (ropivacaine with epinephrine), whereas the control group had no infiltration. Pain intensity was measured with a visual analogue scale (VAS) for the duration of hospital stay and analgaesic consumption. Length of hospital stay, time to get out of bed alone and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index at 3, 6 and 12 months were recorded to evaluate recovery. Per- and postoperative bleeding were evaluated using direct and indirect criteria (operative blood loss, haemoglobin, estimation of uncompensated blood loss and red blood cell transfusion).
  
  
  
  Patients with LIA had significantly less pain during the first 24 h (p = 0.04). No significant differences were found in terms of analgaesic consumption (p = 0.57), early and delayed recovery or bleeding between groups.
  
  
  
  Operative wound infiltration of LIA reduced acute pain after primary THA but did not improve recovery or influence per- and postoperative bleeding.
authors.affiliation: Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France. guillaumevillatte@hotmail.fr.|Laboratory C-Biosenss EA 4676, Clermont-Ferrand University, Université d'Auvergne, 63000, Clermont-Ferrand, France. guillaumevillatte@hotmail.fr.
authors.forename: Guillaume
authors.identifier: 0000-0002-4322-6304
authors.initials: G
authors.lastname: Villatte
authors.affiliation: Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Emilien
authors.initials: E
authors.lastname: Engels
authors.affiliation: Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Roger
authors.initials: R
authors.lastname: Erivan
authors.affiliation: Department of Biostatistics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Mulliez
authors.affiliation: Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Caumon
authors.affiliation: Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Boisgard
authors.affiliation: Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France.|Laboratory C-Biosenss EA 4676, Clermont-Ferrand University, Université d'Auvergne, 63000, Clermont-Ferrand, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Descamps
mesh_terms: D059787:Acute Pain / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000779:Anesthetics, Local
keywords: Bleeding; LIA; Pain management; THA