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COMPARING THE EFFECTS OF LOCAL INFILTRATION ANALGESIA ON POSTOPERATIVE MORPHINE CONSUMPTION AFTER TOTAL KNEE, HIP AND SHOULDER ARTHROPLASTY
ESRA Academy. Golubovska I. Sep 8, 2016; 138420; 0267 Topic: REGIONAL ANAESTHESIA (RA) TECHNIQUES - CLINICAL IMPLICATIONS
Iveta Golubovska
Iveta Golubovska

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Abstract
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Background and Aims:

Total joint arthroplasties significantly improve the patients' quality of life and function of the joints. Local infiltration analgesia (LIA) has been increasingly utilized to provide postoperative analgesia, ensure early mobilization and rehabilitation for a wide variety of procedures. Our aim was to compare postoperative analgesic effect of LIA after total knee (TKA), hip (THA) and shoulder (TSA) arthroplasties.

Methods:

Data from 3 prospective randomized studies in Hospital of Traumatology and Orthopedics, Riga. Patients undergoing THA randomized in study and control groups – all operated under spinal anesthesia (SA), study group received LIA. TKA patients were randomized to three arms of the study – the control (SA), continuous femoral nerve block (FNB), LIA. In case of TSA control group received general anaesthesia only, second group – preoperative brachial plexus block, third group –  LIA. All patients received multimodal analgesia with intravenous morphine as rescue analgesic. Pain scores at rest and with movement, total opioid consumption to the second post-operative day were analyzed.

Results:

Postoperative pain scores after THA in LIA group were lower compared to control group (p<0.05), overage morphine consumption was also lower in LIA group (p=0.015). Total opiate use after TSA was significantly lower in LIA comparing to control (p=0.035). In case of TKA LIA did not show significant effect on postoperative opioid consumption compared to the control group (p>0.05).

Conclusions:

LIA effectively reduced postoperative morphine consumption after THA and TSA. The results of our study did not demonstrate a decrease in pain or opioid consumption due to LIA after TKA.

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