title: Can local infiltration analgesia increase satisfaction in postoperative short-term pain control in total knee arthroplasty?
abstract: One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient's early functional outcomes.
  
  
  
  Compare length of stay (LOS) short-term pain control, and patients' satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA.
  
  
  
  Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups. The first group received an intraoperative LIA (150 mL mixture of ropivacaine 2.0 mg/mL + ketorolac 30 mg + adrenaline 10 μg/mL) combined to an FNB. The control group had only an FNB. Demographical data and visual analog scale (VAS) score were obtained preoperatively, at 36 h after surgery and at the 15-day follow-up. Patients' satisfaction at 1 month was also evaluated. Statistical analysis data was performed.
  
  
  
  No differences in demographical data and preoperative VAS score were observed between both groups. LIA group had a lower VAS score at 36 h after surgery (1.34 ± 1.31 vs. 3.68 ± 1.932 in the control group, p = 0.00), but these differences were not maintained at the 15-day follow-up (4.51 ± 1.889 vs. 4.11 ± 1.940 in the control group, p > 0.05). LOS and patients' satisfaction were comparable between groups. Patients with LIA had no additional complications.
  
  
  
  LIA is a safe adjuvant to FNB to reduce perioperative pain during the first 36 h after TKA. Its effects wean with time, but do cover the first crucial hours of rehabilitation in a fast-track program. LIA seems don't modify postoperative course nor patient's satisfaction at short-term follow-up. The final impact of LIA on surgical outcome is still to be determined.
authors.affiliation: 1 Quironsalud-Hospital Universitari General de Catalunya, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Barastegui
authors.affiliation: 1 Quironsalud-Hospital Universitari General de Catalunya, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Robert
authors.affiliation: 1 Quironsalud-Hospital Universitari General de Catalunya, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Palau
authors.affiliation: 2 Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Haddad
authors.affiliation: 2 Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Reverte-Vinaixa
authors.affiliation: 1 Quironsalud-Hospital Universitari General de Catalunya, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Lorente
authors.affiliation: 1 Quironsalud-Hospital Universitari General de Catalunya, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Cots
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000627:therapeutic use; D000698:Analgesia; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000077212:Ropivacaine; D020910:Ketorolac
keywords: analgesia; fast-track surgery; local infiltration analgesia