Post-Operative Analgesia Following Total Knee Arthroplasty: A Randomized Controlled Trial Comparing Regional Techniques
Abstract
Regional anaesthetic techniques for the management of post-operative pain following total knee arthroplasty (TKA) are becoming increasingly popular. The purpose of this randomized control trial was to assess whether periarticular infiltration and infusion (LIA and infusion) had a comparable time-to-discharge and analgesic quality to a motor-sparing nerve block (MSNB) technique in patients who have undergone TKA. The study arms included continuous MSNB (n=35, control) and LIA and infusion (n=35, experimental). Continuous anaesthetic infusion of 0.2% Ropivacaine was delivered at a rate of 8ml/hr post-operatively. The primary outcome was time to discharge. Secondary objectives included pain scores at rest and activity, narcotic consumption, patient satisfaction and functional outcomes. Preliminary analysis of 54 patients (MSNB n=29, LIA and infusion n=25) was performed. No significant differences in outcome measures were demonstrated between groups. Based on these early findings, LIA and infusion provides similar clinical and functional outcomes to MSNB following primary TKA.