No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty
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No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty. / Specht, K.; Leonhardt, Jane Schwartz; Revald, Peter; Mandoe, H.; Andresen, E.B.; Brodersen, J.; Kreiner, S.; Kjaersgaard-Andersen, P.
I: Acta Orthopaedica (Print Edition), Bind 82, Nr. 3, 06.2011, s. 315-320.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty
AU - Specht, K.
AU - Leonhardt, Jane Schwartz
AU - Revald, Peter
AU - Mandoe, H.
AU - Andresen, E.B.
AU - Brodersen, J.
AU - Kreiner, S.
AU - Kjaersgaard-Andersen, P.
PY - 2011/6
Y1 - 2011/6
N2 - BACKGROUND AND PURPOSE: Postoperative analgesia after primary total hip arthroplasty (THA) using opioids is associated with troublesome side effects such as nausea and dizziness, and epidural analgesic means delayed mobilization. Thus, local infiltration analgesia (LIA) during surgery prolonged with local infusion analgesia (LINFA) into the soft tissue in the hip region through a catheter in the first postoperative days has gained major interest in THA fast-track settings within a short period of time. LIA at the time of surgery is a validated treatment. We investigated the additional effect of giving postoperative LINFA after THA in patients already having LIA during surgery. PATIENTS AND METHODS: 60 consecutive patients undergoing non-cemented THA were randomized into two groups in a double-blind and controlled study. During surgery, all patients received standardized pain treatment with LIA. Postoperatively, they were treated either with a solution of Ropivacain, Ketorolac, and Adrenaline (LINFA group) or placebo (placebo group) administered through a catheter to the hip 10 and 22 h after surgery. Pain score, opioid consumption, and length of stay (LOS) were evaluated. RESULTS: After adjustment for multiple testing, there was no statistically significant postoperative difference between the LINFA group and the placebo group regarding pain and tiredness. We found some evidence of a short-term effect on nausea and vomiting. Opioid consumption and length of stay were similar in the two groups. INTERPRETATION: We found some evidence of a short-term effect of LINFA on nausea and vomiting, but no evidence of an effect on postoperative pain and tiredness. Thus, LINFA cannot be recommended as a standard pain treatment in patients with THA
AB - BACKGROUND AND PURPOSE: Postoperative analgesia after primary total hip arthroplasty (THA) using opioids is associated with troublesome side effects such as nausea and dizziness, and epidural analgesic means delayed mobilization. Thus, local infiltration analgesia (LIA) during surgery prolonged with local infusion analgesia (LINFA) into the soft tissue in the hip region through a catheter in the first postoperative days has gained major interest in THA fast-track settings within a short period of time. LIA at the time of surgery is a validated treatment. We investigated the additional effect of giving postoperative LINFA after THA in patients already having LIA during surgery. PATIENTS AND METHODS: 60 consecutive patients undergoing non-cemented THA were randomized into two groups in a double-blind and controlled study. During surgery, all patients received standardized pain treatment with LIA. Postoperatively, they were treated either with a solution of Ropivacain, Ketorolac, and Adrenaline (LINFA group) or placebo (placebo group) administered through a catheter to the hip 10 and 22 h after surgery. Pain score, opioid consumption, and length of stay (LOS) were evaluated. RESULTS: After adjustment for multiple testing, there was no statistically significant postoperative difference between the LINFA group and the placebo group regarding pain and tiredness. We found some evidence of a short-term effect on nausea and vomiting. Opioid consumption and length of stay were similar in the two groups. INTERPRETATION: We found some evidence of a short-term effect of LINFA on nausea and vomiting, but no evidence of an effect on postoperative pain and tiredness. Thus, LINFA cannot be recommended as a standard pain treatment in patients with THA
KW - administration & dosage
KW - adverse effects
KW - Aged
KW - Aged,80 and over
KW - Amides
KW - Analgesics
KW - Analgesics,Opioid
KW - Anesthetics,Local
KW - Arthroplasty,Replacement,Hip
KW - Catheters
KW - Denmark
KW - Double-Blind Method
KW - drug therapy
KW - Epinephrine
KW - Female
KW - Humans
KW - Ketorolac
KW - Length of Stay
KW - Male
KW - methods
KW - Middle Aged
KW - Pain Measurement
KW - Pain,Postoperative
KW - PATIENT
KW - Patients
KW - Research
KW - Self Report
KW - semrap-2011-2
KW - time
KW - Treatment Outcome
KW - Vomiting
M3 - Journal article
VL - 82
SP - 315
EP - 320
JO - Acta Orthopaedica
JF - Acta Orthopaedica
SN - 1745-3674
IS - 3
ER -
ID: 37582427