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Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial

PURPOSE: Local infiltration anaesthesia (LIA) consisting of ropivacaine, epinephrine and ketorolac administered at the end of surgery has become the gold standard for postoperative analgesia as it provides improved postoperative pain relief compared to other methods. The use of LIA has retrospective...

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Autores principales: Lapidus, Oscar, Baekkevold, Mathilde, Rotzius, Pierre, Lapidus, Lasse J., Eriksson, Karl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742065/
https://www.ncbi.nlm.nih.gov/pubmed/36504009
http://dx.doi.org/10.1186/s40634-022-00552-1
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author Lapidus, Oscar
Baekkevold, Mathilde
Rotzius, Pierre
Lapidus, Lasse J.
Eriksson, Karl
author_facet Lapidus, Oscar
Baekkevold, Mathilde
Rotzius, Pierre
Lapidus, Lasse J.
Eriksson, Karl
author_sort Lapidus, Oscar
collection PubMed
description PURPOSE: Local infiltration anaesthesia (LIA) consisting of ropivacaine, epinephrine and ketorolac administered at the end of surgery has become the gold standard for postoperative analgesia as it provides improved postoperative pain relief compared to other methods. The use of LIA has retrospectively been shown to be associated with decreased perioperative blood loss. However, no randomised controlled trials have examined the effect of of preoperative LIA on blood loss. This study aimed to compare pre- vs perioperative LIA during TKA surgery, with a primary outcome of perioperative blood loss. METHODS: The present study was performed as a prospective single-center randomised controlled trial. A total of 100 patients undergoing primary TKA between October 2016 and March 2018 were randomised to receive either pre- or perioperative LIA. Perioperative blood loss was measured, as well as pre- and postoperative haemoglobin levels. Postoperative pain was estimated at intervals approximately 24, 48 and 72 hours after surgery; analgesic drug consumption was recorded for each patient, as well as the total length of stay as an in-patient. RESULTS: Ninety six patients received either pre- or perioperative LIA as part of the intervention and control group respectively. Average blood loss was 39% lower in the intervention group at 130 ml vs 212 ml in the control group (p=0.002). No significant difference in haemoglobin drop, postoperative pain or length of hospital stay was found. CONCLUSIONS: Preoperative LIA resulted in a 39% decrease in perioperative blood loss during TKA surgery compared to perioperative administration while providing non-inferior postoperative pain relief.
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spelling pubmed-97420652022-12-13 Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial Lapidus, Oscar Baekkevold, Mathilde Rotzius, Pierre Lapidus, Lasse J. Eriksson, Karl J Exp Orthop Original Paper PURPOSE: Local infiltration anaesthesia (LIA) consisting of ropivacaine, epinephrine and ketorolac administered at the end of surgery has become the gold standard for postoperative analgesia as it provides improved postoperative pain relief compared to other methods. The use of LIA has retrospectively been shown to be associated with decreased perioperative blood loss. However, no randomised controlled trials have examined the effect of of preoperative LIA on blood loss. This study aimed to compare pre- vs perioperative LIA during TKA surgery, with a primary outcome of perioperative blood loss. METHODS: The present study was performed as a prospective single-center randomised controlled trial. A total of 100 patients undergoing primary TKA between October 2016 and March 2018 were randomised to receive either pre- or perioperative LIA. Perioperative blood loss was measured, as well as pre- and postoperative haemoglobin levels. Postoperative pain was estimated at intervals approximately 24, 48 and 72 hours after surgery; analgesic drug consumption was recorded for each patient, as well as the total length of stay as an in-patient. RESULTS: Ninety six patients received either pre- or perioperative LIA as part of the intervention and control group respectively. Average blood loss was 39% lower in the intervention group at 130 ml vs 212 ml in the control group (p=0.002). No significant difference in haemoglobin drop, postoperative pain or length of hospital stay was found. CONCLUSIONS: Preoperative LIA resulted in a 39% decrease in perioperative blood loss during TKA surgery compared to perioperative administration while providing non-inferior postoperative pain relief. Springer Berlin Heidelberg 2022-12-12 /pmc/articles/PMC9742065/ /pubmed/36504009 http://dx.doi.org/10.1186/s40634-022-00552-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Lapidus, Oscar
Baekkevold, Mathilde
Rotzius, Pierre
Lapidus, Lasse J.
Eriksson, Karl
Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
title Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
title_full Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
title_fullStr Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
title_full_unstemmed Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
title_short Preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
title_sort preoperative administration of local infiltration anaesthesia decreases perioperative blood loss during total knee arthroplasty – a randomised controlled trial
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742065/
https://www.ncbi.nlm.nih.gov/pubmed/36504009
http://dx.doi.org/10.1186/s40634-022-00552-1
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