scholarly journals Rapid recovery following hip and knee arthroplasty using local infiltration analgesia: length of stay, rehabilitation protocol and cost savings

2020 ◽  
Vol 90 (3) ◽  
pp. 355-359 ◽  
Author(s):  
Islam Nassar ◽  
Julie Fahey ◽  
David Mitchell
Keyword(s):  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Cost Savings ◽  
Rapid Recovery ◽  
Local Infiltration Analgesia ◽  
Local Infiltration ◽  
Rehabilitation Protocol ◽  
Hip And Knee Arthroplasty ◽  
Infiltration Analgesia

scholarly journals Fast Track Arthroplasty Using Local Infiltration Analgesia

2021 ◽  
Author(s):  
Timothy Cordingley ◽  
Daniel Chepurin ◽  
Ghada Younis ◽  
Islam Nassar ◽  
David Mitchell
Keyword(s):  
Knee Arthroplasty ◽  
Fast Track ◽  
Holistic Approach ◽  
Good Alternative ◽  
Early Mobilisation ◽  
Local Infiltration Analgesia ◽  
Local Infiltration ◽  
Hip And Knee Arthroplasty ◽  
And Function ◽  
Infiltration Analgesia

Fast track arthroplasty is a holistic approach to patients who undergo total hip and knee arthroplasty, a journey or care that begins with setting patient’s expectation, optimising medical status, using intraoperative local anaesthetic infiltra-tion, decreasing narcotics usage either in spinal or post-operative medication, discouraging usage of patient controlled analgesia or urinary catheters, encouraging day of operation mobilisation and optimising post-operative physiotherapy protocols. The use of local infiltration analgesia (LIA) is a good alternative compared to other traditional pain management techniques. The purpose of adoption of LIA technique is to provide comfort from the trauma associated with hip and knee arthroplasty particularly for the first 36 h post-operatively, during the time of high post-operative pain, to facilitate increased post-operative mobilisation and function. LIA is safe and effective to achieve good outcomes, early mobilisation and decreasing length of stay without jeopardising clinical outcomes. This chapter discusses LIA and its multimodal approach to analgesia, regional anaesthesia and early mobilisation that improves overall patient experience and satisfaction. The chapter discusses LIA techniques, wound catheter placement, and postoperative protocol to achieve fast track hip and knee arthroplasty.

scholarly journals Comparison of continuous femoral nerve block with local infiltration for postoperative analgesia in unilateral total knee arthroplasty- a randomized controlled trial

2019 ◽  
pp. 268-273
Author(s):  
Rohit Kumar Varshney ◽  
Mukesh Kumar Prasad ◽  
Megha Garg
Keyword(s):  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Controlled Trial ◽  
Femoral Nerve ◽  
Local Infiltration Analgesia ◽  
Local Infiltration ◽  
Total Knee ◽  
Infiltration Analgesia

Background & Objective: Local infiltration of knee joints during knee joint surgery has been used for postoperative analgesia with preservation of motor function of quadriceps muscle, which helps in early mobilization. Femoral nerve block has been incriminated with paralyses of vastus medialis muscle. We aimed to compare postoperative analgesia between femoral nerve block and local infiltration in patients undergoing unilateral total knee arthroplasty (TKA).Methodology: After obtaining institutional ethical approval and written informed consent from the patients, this randomized controlled trial was conducted at Department of Anesthesia at Teerthankar Mahaveer Medical College & Research Centre between July - December 2018. The study was conducted on 60 patients of ASA I and II, undergoing unilateral total TKA. Patients were randomly divided into two groups: Group FB patients underwent femoral nerve block, and Group LI patients underwent local infiltration analgesia. Sedation score, numeric rating scale, motor power and frequency of nausea/vomiting were recorded and statistical analysis done.Results: We observed better pain relief in patients which received femoral nerve block as compared to local infiltration analgesia (p < 0.001). Sedation score was higher in Group LI and was statistically significant between the two groups at 4th, 12th, and 48th hour (p < 0.05). Group FB patients were associated with higher muscle power grades (p < 0.001) as compared to local infiltration analgesia patients. Fentanyl demand was observed to be lesser in Group FB as compared to Group LI (p < 0.001).Conclusion: The study concludes that femoral nerve block produces better pain reliefin patients posted for unilateral knee arthroplasty as compared to local infiltration ofthe local anesthetic solution. However, there is gross reduction in range of motion withfemoral nerve block.Citation: Varshney RK, Prasad MK, Garg M. Comparison of continuous femoral nerve block with local infiltration for postoperative analgesia in unilateral total knee arthroplasty - a randomized controlled trial. Anaesth pain & intensive care 2019;23(3):268-273

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