Local Infiltration Analgesia found to be better than Other Techniques for Early Functional Recovery and Pain Control in Total Knee Arthroplasty

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Local Infiltration Analgesia found to be better than Other Techniques for Early Functional Recovery and Pain Control in Total Knee Arthroplasty

The local infiltration analgesia (LIA) emerges as an effective and safe method for controlling pain and functional recovery during total knee arthroplasty (TKA). The evidence for LIA effectiveness was provided by a recent study published in BMC Musculoskeletal Disorders. After total knee arthroplasty, improved muscle strength, mobilization, the range of motion along with postoperative pain management are the crucial necessities to gain early recovery and rehabilitation. The general anaesthesia, spinal anaesthesia, peripheral nerve blocks and LIA are some measures through which the optimal pain management and rapid functional recovery after TKA can be obtained.

M. T. Berninger and colleagues selected a total of 280  patients who went through TKA from Jan 2016 to Aug 2016 for the assessment. These patients were categorized into four classes as per their anaesthetic therapy and related pain. First class was GA&FNB which involved 81 patients who received catheter-based treatments of sciatic and femoral nerve block. The second class was SP&EPI that comprised 51 patients who received an epidural catheter along with spinal or general anaesthesia. The third class was GA&LIA involved 86 patients who went through general anaesthesia along with LIA. The fourth group was  SP&LIA involved 61 patients who received spinal anaesthesia with LIA. The pain, muscle strength, range of motion and mobilization up to 7 days were measured as outcomes. The cumulative intake of pain medicine was also evaluated.

All groups exhibited the same pain relief NRS scores, but the group SP&EPI showed significant lower opioid intake up to 58% as compared to other groups. Higher muscle strength up to 20% and mobilization up to 26% was noticed in LIA groups. No complications were seen in any group in the first seven days after therapies. However, 12.2% of patients from the LIA class and 8.4% patients from catheter-based class were shifted to other anaesthetic pain medications due to inadequate pain relief. Despite that, LIA found to be an effective and safe method for early functional recovery and pain control due to better and higher muscle strength and mobilization as compared to other groups.

Source

BMC Musculoskelet Disord     

Link:

https://www.ncbi.nlm.nih.gov/pubmed/30021587

The original title of article:

Effect of local infiltration analgesia, peripheral nerve blocks, general and spinal anaesthesia on early functional recovery and pain control in total knee arthroplasty

Authors:

M. T. Berninger et al.

SearchTags: 
Therapeutic, Knee Pain, Knee, General Anesthesia, Spinal Anesthesia, Efficacy, NRS
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