title: Continuous intraarticular and periarticular levobupivacaine for management of pain relief after total knee arthroplasty: A prospective randomized, double-blind pilot study.
abstract: BACKGROUND
  Total knee arthroplasty (TKA) can result in major postoperative pain which can impact the recovery and rehabilitation of patients and for this reason the use of a pain-control infusion pumps (PCIP) enhances analgesia for TKA.
  
  
  OBJECTIVE
  To investigate whether a PCIP of levobupivacaine would reduce pain in patients following TKA.
  
  
  METHODS
  This was a prospective, randomized, controlled study conducted in 55 patients. Criteria for participation were unilateral TKA for osteoarthritis and no allergies to levobupivacaine. The primary outcomes measured were postoperative pain intensity on Visual Analogue Scale (VAS) score measured at 24 h and 48 h. Other measures included amount of narcotics, presence of adverse events, and length of hospital stay.
  
  
  RESULTS
  PCIP-treated patients (n = 28) showed significant reductions in VAS score at any time versus control (p < 0.01). Amount of narcotics, presence of adverse events, and length of hospital stay were significantly less with the PCIP versus control (each p < 0.01).
  
  
  CONCLUSIONS
  The use of a mix of levobupivacaina, ketoral-trometamina, and adrenalin provides a safe and effective means in post-operative pain relief in patients undergoing TKA.
  
  
  METHODS
  Level II therapeutic study.
authors.affiliation: Department of Orthopaedic Surgery, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Francesco
authors.affiliation: Department of Orthopaedic Surgery, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Flamini
authors.affiliation: Department of Orthopaedic Surgery, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pizzoferrato
authors.affiliation: Department of Anesthesiology, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fusco
authors.affiliation: University of Study L'Aquila, Department of Orthopaedic Surgery, San Salvatore Hospital, via Vetoio, N° 1, 67100 L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Paglia
keywords: Levobupivacaine; Pain-control infusion pumps (PCIP); Postoperative outcomes; Total knee arthroplasty