TITLE:
Comparason of Peri-Articular Multimodal Drug Injection with Femoral and Sciatic Nerve Block after Total Knee Arthroplasty
AUTHORS:
Calum H. C. Arthur, Alexander M. Wood, Charles Leeson-Payne, Steffen J. Breusch
KEYWORDS:
Analgesia; Total Knee Replacement; Multimodal Drug Injection; Peripheral Nerve Blocks; Rehabilitation
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.2 No.4,
December
31,
2012
ABSTRACT: Good perioperative analgesia following total knee
arthroplasty facilitates rehabilitation and may reduce hospital stay. We
present the patient analgesic requirements and rehabilitation of a prospective
single surgeon series after the introduction of a multimodal drug injection during his
total knee arthroplasty. Basic epidemiological data as well as analgesic, antiemetic
requirements and time to straight leg raised was collected on 27 consecutive
patients (group 1) whom received the multimodal drug injection, consisting of
levobupivacaine, ketorolac and adrenaline at the time of their total knee
arthroplasty under spinal anaesthesia. Their rehabilitation was compared to a
retrospective review of patients who were case matched by age and sex (group 2n = 26), whom had received
the unit standard of spinal anaesthetic and a femoral and sciatic block at the
time of their operation. Patients in group 1 had significantly lower
analgesic and antiemetic requirements than group 2. Group 1 also had
a significantly shorter hospital stay. We have demonstrated that periarticular multimodal
drug injection can improve perioperative analgesia and mobilisation following
total knee arthroplasty as well as reducing opioid requirements
and side effects.