Efficacy of Multimodal Peri- and Intraarticular Drug Injections in Total Knee Arthroplasty

Efficacy of Multimodal Peri- and Intraarticular Drug Injections in Total Knee Arthroplasty

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:

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.

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.

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