Open AccessReduced Opioid Consumption and Improved Early Rehabilitation with Local and Intraarticular Cocktail Analgesic Injection in Total Hip Arthroplasty: A Randomized Controlled Clinical Trial
Author(s) -
Liu Wei,
Cong Ruijun,
Li XiaoHua,
Wu Yuli,
Wu Haishan
Publication year - 2011
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2010.01043.x
Subject(s) - medicine , anesthesia , analgesic , visual analogue scale , placebo , randomized controlled trial , morphine , arthroplasty , range of motion , opioid , rehabilitation , betamethasone , surgery , physical therapy , alternative medicine , receptor , pathology
Objective. Postoperative pain after total hip arthroplasty (THA) is not well tolerated. We assessed postoperative pain relief and the need for opioid use after using a cocktail of local and intraarticular analgesic injection (LIA) after THA. Methods. Eighty patients undergoing THA under spinal anesthesia were randomly assigned to receive either LIA or placebo. The LIA was composed of 5 mg morphine, 30 mg bupivacaine (15 mg/1.5 mL), 1 mL betamethasone, and 0.5 mL epinephrine (1:1,000) intraoperatively. We compared three outcomes total morphine consumption, visual analog scale (VAS) at rest and during activity, and hip flexion angle while standing. Results. When compared with placebo, opioid consumption was significantly reduced in the trial group, as well as VAS at rest and during mobilization. Earlier rehabilitation and better range of motion (ROM) were achieved in the trial group. There were no significant differences in side effects or postoperative wound healing between groups. Conclusion. In patients undergoing THA, LIA may reduce postoperative systemic opioid use and offer better pain control and earlier rehabilitation, without observable risks.