TY - JOUR
T1 - Efficacy of multimodal perioperative analgesia protocol with periarticular medication injection in total knee arthroplasty
T2 - A randomized, double-blinded study
AU - Kelley, Todd C.
AU - Adams, Mary Jo
AU - Mulliken, Brian D.
AU - Dalury, David F.
PY - 2013/9
Y1 - 2013/9
N2 - Pain control is necessary for successful rehabilitation and outcome after total knee arthroplasty. Our goal was to compare the clinical efficacy of periarticular injections consisting of a long-acting local anesthetic (ropivacaine) and epinephrine with and without combinations of an α2-adrenergic agonist (clonidine) and/or a nonsteroidal anti-inflammatory agent (ketorolac). In a double-blinded controlled study, we randomized 160 patients undergoing total knee arthroplasty to receive 1 of 4 intraoperative periarticular injections: Group A, ropivacaine, epinephrine, ketorolac, and clonidine; Group B, ropivacaine, epinephrine, and ketorolac; Group C, ropivacaine, epinephrine, and clonidine; Group D (control), ropivacaine and epinephrine. Compared with Group D, Group A and B patients had significantly lower postoperative visual analog pain scores and nurse pain assessment and Group C patients had a significantly greater reduction in physical therapist pain assessment. We found no differences in other parameters analyzed.
AB - Pain control is necessary for successful rehabilitation and outcome after total knee arthroplasty. Our goal was to compare the clinical efficacy of periarticular injections consisting of a long-acting local anesthetic (ropivacaine) and epinephrine with and without combinations of an α2-adrenergic agonist (clonidine) and/or a nonsteroidal anti-inflammatory agent (ketorolac). In a double-blinded controlled study, we randomized 160 patients undergoing total knee arthroplasty to receive 1 of 4 intraoperative periarticular injections: Group A, ropivacaine, epinephrine, ketorolac, and clonidine; Group B, ropivacaine, epinephrine, and ketorolac; Group C, ropivacaine, epinephrine, and clonidine; Group D (control), ropivacaine and epinephrine. Compared with Group D, Group A and B patients had significantly lower postoperative visual analog pain scores and nurse pain assessment and Group C patients had a significantly greater reduction in physical therapist pain assessment. We found no differences in other parameters analyzed.
KW - Clonidine
KW - Ketorolac
KW - Multimodal pain management
KW - Outcomes
KW - Periarticular injection
KW - Total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84883210118&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883210118&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2013.03.008
DO - 10.1016/j.arth.2013.03.008
M3 - Article
C2 - 23608085
AN - SCOPUS:84883210118
SN - 0883-5403
VL - 28
SP - 1274
EP - 1277
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 8
ER -