Intra-articular local anaesthetic on the day after surgery improves pain and patient satisfaction after Unicompartmental Knee Replacement: a randomised controlled trial.

Journal article

Intra-operative local anaesthetic infiltration provides good early pain relief after Unicompartmental Knee Replacement (UKR). However, appreciable pain may occur on the day after surgery. The purpose of this double-blinded, prospective randomised controlled trial was to evaluate the effectiveness of a bolus of local intra-articular anaesthetic given early on the day after surgery. Forty-four patients were randomised to receive an intra-articular injection, via an epidural catheter inserted at operation, of either 20 ml 0.5% plain bupivacaine or 20 ml normal saline. All patients received a femoral nerve block with 20 ml prilocaine 1% and local anaesthetic infiltration by the surgeon. Patients injected with bupivacaine had significantly less (p<0.001) pain than control patients immediately (mean pain score 1.82 v 6.1) and 6 hours (2.5 v 5.7) after injection. Patient satisfaction was also significantly greater (p<0.001) in the local anaesthetic group. We conclude that a bolus dose of intra-articular bupivacaine early on the day after surgery dramatically improves pain control after UKR and improves patient satisfaction.

Authors: Weston-Simons, J; Pandit, H; Haliker, V; Dodd, C; Popat, M

• Publication status: Published
• Journal: Knee
• Volume: 19
• Issue: 4
• Pages: 352-355
• Publication date: 2012-08-01
• DOI: 10.1016/j.knee.2011.04.010
• EISSN: 1873-5800
• ISSN: 0968-0160
• Language: English
• Keywords: Injections, Intra-Articular; Osteoarthritis, Knee; Anesthetics, Local; Pain, Postoperative; Double-Blind Method; Patient Satisfaction; Bupivacaine; Arthroplasty, Replacement, Knee; Humans