Efficacy of multimodal perioperative analgesia protocol with periarticular medication injection in total knee arthroplasty: A randomized, double-blinded study

Todd C. Kelley, Mary Jo Adams, Brian D. Mulliken, David F. Dalury

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1274-1277
Number of pages4
JournalJournal of Arthroplasty
Volume28
Issue number8
DOIs
StatePublished - Sep 2013

Keywords

  • Clonidine
  • Ketorolac
  • Multimodal pain management
  • Outcomes
  • Periarticular injection
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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