Efficacy of Multimodal Peri- and Intraarticular Drug Injections in Total Knee Arthroplasty
Overview
- Phase
- Phase 4
- Intervention
- ropivacaine
- Conditions
- Osteoarthritis of the Knee
- Sponsor
- Asker & Baerum Hospital
- Enrollment
- 102
- Locations
- 1
- Primary Endpoint
- Pain at Rest (VAS)
- Status
- Completed
- Last Updated
- 14 years ago
Overview
Brief Summary
Total knee arthroplasty (TKA) is associated with moderate to severe postoperative pain, causing patient discomfort, mobilisation and hospital discharge.
The aim of this study is to:
- Compare analgetic efficacy of to types of local infiltration analgesia in total knee arthroplasty.
- Compare analgetic efficacy of local infiltration analgesia with continuous epidural analgesia.
Detailed Description
Total knee arthroplasty (TKA) is increasingly common in the treatment of knee osteoarthritis. TKA is associated with moderate to severe postoperative pain, causing patient discomfort, mobilisation and hospital discharge. Continuous epidural analgesia is often used for controlling pain after TKA. Recent studies describe a new method for pain control after total knee arthroplasty which consists of local infiltration with local anesthetics and adrenaline. This infiltrations can be combined with ketorolac and/or morphine. The aim of this study is to: 1. Compare analgetic efficacy of to types of local infiltration analgesia in total knee arthroplasty. 2. Compare analgetic efficacy of local infiltration analgesia with continuous epidural analgesia.
Investigators
Eligibility Criteria
Inclusion Criteria
- •patients at least 18 years of age
- •scheduled for elective total knee arthroplasty
- •ASA I-III
- •signed written informed consent
Exclusion Criteria
- •age \< 18
- •ASA \> III
- •moderate or severe cardiac disease, bronchial asthma
- •allergy against ropivacaine, ketorolac or morphine
- •analgetic abuse
- •pregnancy or nursing women
- •severe psychiatric disease
- •moderate to severe dementia
Arms & Interventions
LIA IV
Local infiltration analgesia with ropivacaine and adrenaline and intravenous ketorolac and morphine
Intervention: ropivacaine
LIA IV
Local infiltration analgesia with ropivacaine and adrenaline and intravenous ketorolac and morphine
Intervention: adrenaline
LIA IV
Local infiltration analgesia with ropivacaine and adrenaline and intravenous ketorolac and morphine
Intervention: ketorolac
LIA IV
Local infiltration analgesia with ropivacaine and adrenaline and intravenous ketorolac and morphine
Intervention: morphine
LIA IA
Local infiltration analgesia with ropivacaine, adrenaline and ketorolac and morphine
Intervention: ropivacaine
LIA IA
Local infiltration analgesia with ropivacaine, adrenaline and ketorolac and morphine
Intervention: adrenaline
LIA IA
Local infiltration analgesia with ropivacaine, adrenaline and ketorolac and morphine
Intervention: ketorolac
LIA IA
Local infiltration analgesia with ropivacaine, adrenaline and ketorolac and morphine
Intervention: morphine
EDA
standard continuous epidural analgesia
Intervention: adrenaline
EDA
standard continuous epidural analgesia
Intervention: fentanyl
EDA
standard continuous epidural analgesia
Intervention: bupivacaine
Outcomes
Primary Outcomes
Pain at Rest (VAS)
Time Frame: 48 hours postoperative
VAS (pain at rest) 0-100 mm. VAS 0 mm means no pain and VAS 100 mm means maximal pain.
Secondary Outcomes
- Opioid Use(48 hours postoperative)
- Time to Readiness for Discharge(up to 10 days postoperative)