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Related Experiment Videos

A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study.

Pascal-André Vendittoli1, Patrice Makinen, Pierre Drolet

  • 1Orthopaedic Surgery Unit, Department of Surgery, Maisonneuve-Rosemont Hospital, 5345 boul l'Assomption, Suite 55, Montreal, Quebec H1T 4B3, Canada. pa.vendittoli@sympatico.ca

The Journal of Bone and Joint Surgery. American Volume
|February 3, 2006
PubMed
Summary

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Local anesthetic infiltration significantly reduced morphine use and nausea after total knee arthroplasty. This multimodal approach offers improved pain control and safety for patients undergoing knee surgery.

Area of Science:

  • Orthopedics
  • Anesthesiology
  • Pain Management

Background:

  • Parenteral narcotics are standard for postoperative pain management after total knee arthroplasty (TKA).
  • Local anesthetics offer targeted pain relief at the origin, potentially reducing systemic side effects.
  • There is a need for effective multimodal analgesia protocols for TKA.

Purpose of the Study:

  • To evaluate the benefits and safety of a multimodal analgesia protocol using periarticular local anesthetic injection for TKA.
  • To compare morphine consumption and pain control between patients receiving local analgesia and those receiving only morphine.

Main Methods:

  • A randomized study compared a perioperative local anesthetic infiltration with self-administered morphine versus self-administered morphine alone in 42 TKA patients.

Related Experiment Videos

  • Morphine consumption, pain control, side effects, local anesthetic plasma levels, and rehabilitation were monitored.

    • Main Results:

    • The local analgesia group consumed significantly less morphine (28.8 mg vs. 50.3 mg at 24 hours) and reported less nausea (2.6 hours vs. 7.1 hours over 5 days).
    • Both groups achieved similar knee flexion, and no local anesthetic toxicity was observed.
    • High patient satisfaction and good pain control were noted in both groups.

    Conclusions:

    • A multimodal perioperative analgesia protocol with local anesthetic infiltration improves pain control and minimizes side effects in TKA patients.
    • The safety of this local anesthetic infiltration protocol was confirmed.
    • This approach offers a promising alternative to traditional narcotic-based pain management after TKA.