scholarly journals Helyi infiltrációs érzéstelenítés alkalmazása nagyízületi endoprotézisek beültetése során

2017 ◽  
Vol 158 (9) ◽  
pp. 352-357 ◽  
Author(s):  
Tamás de Jonge ◽  
Szabolcs Görgényi ◽  
Gabriella Szabó ◽  
Miklós Bulcsú Torkos
Keyword(s):  
Postoperative Pain ◽  
Knee Replacement ◽  
Control Group ◽  
Local Infiltration Analgesia ◽  
Local Infiltration ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
The Cost ◽  
Infiltration Analgesia

Abstract: Introduction: Total hip and knee replacment surgeries are characterized by severe postoperative pain. Local infiltration analgesia is proved to be very effective. However this method has not been widely used in Hungary. Aim: To evaluate the efficacy of the local infiltration analgesia with modified components in patients underwent total hip or knee replacement surgery. Method: Data of 99 consecutive patients underwent primary total hip or knee replacement surgery were evaluated prospectively. In all the 99 surgeries modified local infiltration analgesia was applied. Postoperative pain reported on a visual analog scale was recorded as well as the need for further analgetics during the first 18 hours after surgery. The cost of the analgetic drugs was calculated. The control group comprised 97 consecutive patients underwent total hip or knee replacement, where local infiltration analgesia was not applied. Statistical analysis was done. Results: Patients received local infiltration analgesia reported significantly less pain (p<0.001). The need for postoperatively given analgetics was almost 50% less, and the cost of all postoperative analgetics was 47% less than in the control group. Conclusion: In total hip and knee replacement surgeries the modified local infiltration analgesia decreases postoperative pain effectively and contribute to the early mobilization of the patients. Orv. Hetil., 2017, 158(9), 352–357.

Comparison between ropivacaine local infiltration analgesia with ketorolac or placebo for total knee replacement surgery

2012 ◽  
Vol 3 (3) ◽  
pp. 196-197
Author(s):  
K.V. Andersen ◽  
L. Nikolajsen ◽  
V. Haraldsted ◽  
N.T. Andersen ◽  
C.F. Jepsen ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Length Of Hospital Stay ◽  
Local Infiltration Analgesia ◽  
Local Infiltration ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee ◽  
Infiltration Analgesia

AbstractBackground/aimsOptimal pain treatment with minimal side-effects is essential for early mobilization and recovery in patients undergoing total knee replacement surgery. Local infiltration analgesia (LIA) with local anaesthetic might be effective and adjuncts such as ketorolac may provide additional effects on opioid requirements and pain. We tested the hypothesis that adding ketorolac significantly improves analgesia after total knee replacement surgery.MethodsSixty patients were enrolled in this prospective double-blinded study and allocated to either group R (placebo) or Group RK (ketorolac 120 mg). All patients received high-volume LIA with 150 ml ropivacaine (300 mg) with epinephrine added either placebo or ketorolac (30 mg) combined with eight 10 ml ropivacaine doses (100 mg) added either placebo or ketorolac (15 mg) administered every 6 h through an intra-articular catheter for 48 h. postoperatively. The primary outcome was patient-controlled morphine consumption from 0–6 and 0–48 h after surgery. Time to first rescue administration, pain intensity (0–100 mm visual analogue scale) at rest and during mobilization and side-effects were recorded until 96 h after surgery.ResultsSix and forty-eight morphine consumption was significantly reduced in group RK compared with group R. Time to first rescue analgesia was significantly prolonged with 4 h in group RK [median (IQR)] 490 min (248–617) compared with 223 min (115–319) group R (P < 0.02). Pain at rest and during movement was significantly reduced for 48 h with the addition of ketorolac. Length of hospital stay was reduced with one day in group RK [median (IQR)] 2 days (2–3) compared with group R3 days (2–3) (P =0.004).ConclusionsKetorolac resulted in a 75% reduction in 48 h postoperative morphine requirements. This was also significantly associated with prolonged analgesia, reduced pain intensity scores at rest and during movement and reduced length of hospital stay.

Patient Blood Management in Elective Total Hip- and Knee-replacement Surgery (Part 2)

2014 ◽  
Vol 120 (4) ◽  
pp. 852-860 ◽  
Author(s):  
Cynthia So-Osman ◽  
Rob G. H. H. Nelissen ◽  
Ankie W. M. M. Koopman-van Gemert ◽  
Ewoud Kluyver ◽  
Ruud G. Pöll ◽  
...  
Keyword(s):  
Knee Replacement ◽  
Control Group ◽  
Transfusion Rate ◽  
Cell Saver ◽  
Patient Blood Management ◽  
Blood Management ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
Preoperative Hemoglobin

Abstract Background: Patient blood management is introduced as a new concept that involves the combined use of transfusion alternatives. In elective adult total hip- or knee-replacement surgery patients, the authors conducted a large randomized study on the integrated use of erythropoietin, cell saver, and/or postoperative drain reinfusion devices (DRAIN) to evaluate allogeneic erythrocyte use, while applying a restrictive transfusion threshold. Patients with a preoperative hemoglobin level greater than 13 g/dl were ineligible for erythropoietin and evaluated for the effect of autologous blood reinfusion. Methods: Patients were randomized between autologous reinfusion by cell saver or DRAIN or no blood salvage device. Primary outcomes were mean intra- and postoperative erythrocyte use and proportion of transfused patients (transfusion rate). Secondary outcome was cost-effectiveness. Results: In 1,759 evaluated total hip- and knee-replacement surgery patients, the mean erythrocyte use was 0.19 (SD, 0.9) erythrocyte units/patient in the autologous group (n = 1,061) and 0.22 (0.9) erythrocyte units/patient in the control group (n = 698) (P = 0.64). The transfusion rate was 7.7% in the autologous group compared with 8.3% in the control group (P = 0.19). No difference in erythrocyte use was found between cell saver and DRAIN groups. Costs were increased by €298 per patient (95% CI, 76 to 520). Conclusion: In patients with preoperative hemoglobin levels greater than 13 g/dl, autologous intra- and postoperative blood salvage devices were not effective as transfusion alternatives: use of these devices did not reduce erythrocyte use and increased costs.

Investigating the Effect of Perioperative Chlorzoxazone on Acute Postoperative Pain After Total Hip and Knee Replacement Surgery

2020 ◽  
Vol 36 (5) ◽  
pp. 352-358
Author(s):  
Peter Skrejborg ◽  
Kristian K. Petersen ◽  
Jacob Beck ◽  
Michael Ulrich ◽  
Ole Simonsen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Knee Replacement ◽  
Acute Postoperative Pain ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery

FRI0599-HPR Preoperative physical therapy in total hip and knee replacement surgery: a multi center study.

2013 ◽  
Vol 72 (Suppl 3) ◽  
pp. A578.3-A578
Author(s):  
W. F. Peter ◽  
C. Tilbury ◽  
R. Tordoir ◽  
S. H. Verdegaal ◽  
R. Onstenk ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Knee Replacement ◽  
Knee Replacement Surgery ◽  
Total Hip ◽  
Replacement Surgery ◽  
Multi Center Study ◽  
Center Study

Effect of systematic local infiltration analgesia on postoperative pain in vaginal hysterectomy: a randomized, placebo-controlled trial

2014 ◽  
Vol 93 (3) ◽  
pp. 233-238 ◽  
Author(s):  
Ana-Marija Hristovska ◽  
Billy B. Kristensen ◽  
Marianne A. Rasmussen ◽  
Yvonne H. Rasmussen ◽  
Lisbeth B. Elving ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Vaginal Hysterectomy ◽  
Controlled Trial ◽  
Local Infiltration Analgesia ◽  
Local Infiltration ◽  
Infiltration Analgesia
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