Effect of Local Anaesthetic Wound Infiltration on Acute Pain and Bleeding After Primary Total Hip Arthroplasty: the EDIPO Randomised Controlled Study

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2016 Feb 23

PMID 26899484

Citations 17

Authors

Guillaume Villatte

Emilien Engels

Roger Erivan

Aurelien Mulliez

Nicolas Caumon

Stephane Boisgard

Stephane Descamps

Affiliations

Soon will be listed here.

Abstract

Purpose: 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.

Methods: 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).

Results: 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.

Conclusions: Operative wound infiltration of LIA reduced acute pain after primary THA but did not improve recovery or influence per- and postoperative bleeding.

Citing Articles

Periarticular infiltration used in total joint replacements: an update and review article.

King G, Le A, Nickol M, Sarkis B, van der Merwe J J Orthop Surg Res. 2023; 18(1):859.

PMID: 37957753 PMC: 10641975. DOI: 10.1186/s13018-023-04333-z.

[Analgesic effect of a new "cocktail" of local infiltration analgesia after total hip arthroplasty-A prospective randomized controlled study].

Yang Q, Wang H, Xiao Q, Luo Z, Zhou Z Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022; 36(12):1485-1491.

PMID: 36545856 PMC: 9763061. DOI: 10.7507/1002-1892.202209003.

A new cocktail formula with diprospan of local infiltration analgesia in primary total hip arthroplasty: A prospective, randomized, controlled, observer-blinded study.

Wang H, Xiao Q, Luo Z, Pei F, Wang D, Zhou Z Orthop Surg. 2022; 14(8):1799-1807.

PMID: 35822607 PMC: 9363723. DOI: 10.1111/os.13288.

The effects of adding local infiltration analgesia of the knee to a multimodal pain protocol for total arthroplasty: A matched pair retrospective study.

Selznick A, Chhina T, Sennik V, Tam K, El Beheiry H Can J Pain. 2022; 3(1):98-105.

PMID: 35005398 PMC: 8730671. DOI: 10.1080/24740527.2019.1603077.

Local infiltration analgesia with bupivacaine and adrenaline does not reduce perioperative blood loss in total hip arthroplasty.

Ceynowa M, Sikora T, Roclawski M, Treder M, Kolarz K, Pankowski R PLoS One. 2021; 16(9):e0257202.

PMID: 34499694 PMC: 8428560. DOI: 10.1371/journal.pone.0257202.

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