Efficiency of the Local Infi ltration Analgesia Method in Total Knee Artroplasty Surgeries.

Résumé

PURPOSE OF THE STUDY: Postoperative pain after total knee arthroplasty (TKA) is severe because of bone and soft tissue trauma during the surgery and is diffi cult to control with oral analgesics. The primary aim of the study was to investigate the effects of the local infi ltration anesthesia (LIA) method on postoperative analgesia quality and opioid consumption in patients undergoing TKA. The secondary aims were to evaluate knee fl exion angle, side effects, and patient satisfaction. MATERIAL AND METHODS Total 40 patients, who underwent unilateral TKA surgery under spinal anesthesia were included in the prospective randomized study. Patients who underwent patient-controlled intravenous analgesia (PCA) (Group A) or LIA + PCA (Group B), were divided into two groups, randomly. For LIA application, 0.25% bupivacaine solution 150 mg in 60 ml volume was used. The postoperative pain was evaluated in 48th hour after the recovery of motor block, and during exercise at 24, 36, and 48 hours by using the visual analogue scale (VAS). An additional morphine was administered with the PCA device when VAS ≥ 4. The total amount of morphine consumption and the side effects were recorded. The knee fl exion joint angles at the 48th hour and the patients' satisfaction was recorded. RESULTS Resting VAS values were lower in Group B in the fi rst 24 hours (p