Korean J Anesthesiol.  2007 Oct;53(4):486-490. 10.4097/kjae.2007.53.4.486.

The Efficacy of Intra-articular Infusion of Ropivacaine after Total Knee Arthroplasty

• Lee HJ
• Woo YK

• KMID: 2236598
• DOI: http://doi.org/10.4097/kjae.2007.53.4.486

Abstract

BACKGROUND: Intravenous patient controlled analgesia may not provide complete postoperative analgesia following total knee arthroplasty. The present study was to evaluate whether the addition of local, intra-articular ropivacaine improves the quality of the analgesia after total knee arthroplasty.
METHODS
In the prospective, double-blind trial, 17 patients undergoing total knee arthroplasty of both knees with a standard general anesthetic technique had a infusion catheter placed at each knee joint at the end of surgery. The first knee joints were randomly assigned to receive a bolus of 20 ml 0.75% ropivacaine or saline followed by continuous infusion at 2 ml/h for 48 hours. The later knee joints received saline or ropivacaine that was not administered in the first knee joints in same manner. All patients received IV PCA. The difference in pain for each knee was assessed before surgery and at 2, 4, 6, 12, 24, 36 and 48 hours postoperatively. The use of a visual analogue scale (VAS) for each knee was also assessed at 2, 4, 6, 12, 24, 36 and 48 hours postoperatively.
RESULTS
The difference in pain between each knee significantly increased at 4, 6, 12, 24, 36, 48 hours. However, the VAS in the ropivacaine-infused knee was significantly lower than that in the saline-infused knee at 12 and 24 hours.
CONCLUSIONS
These results suggest that an intra-articular infusion of a bolus of 20 ml followed by continuous infusion at 2 ml/h with 0.75% ropivacaine after total knee arthroplasty has only a marginal analgesic effect.

Keyword

intra-articular analgesia; patient-controlled analgesia; postoperative pain; ropivacaine; total knee arthroplasty

MeSH Terms

Analgesia
Analgesia, Patient-Controlled
Arthroplasty*
Catheters
Humans
Knee Joint
Knee*
Pain, Postoperative
Passive Cutaneous Anaphylaxis
Prospective Studies