Study supports periarticular levobupivacaine for pain relief after knee replacement

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The findings suggests periarticular infiltration of anaesthetic is a viable and safe alternative to femoral nerve block.

Periarticular levobupivacaine is a good alternative to femoral nerve block for managing pain following total knee arthroplasty (TKA) and may reduce patients’ requirements for additional morphine following the procedure, concludes a new study published in the Bone & Joint Journal .
For the study, 262 people were randomised to receive either a femoral nerve block, or periarticular infiltration of local anaesthetic.

Pain scores on the day after TKA were the same in patients who have had a femoral nerve block and those who have had periarticular infiltration of local anaesthetic. The study also found the periarticular group used less morphine in the first post-operative day compared with the femoral nerve block group.

The proportion of patients able to transfer from bed to chair independently on the first post-operative day and the mean time in seconds to get up and go on the second post-operative day, were both marginally in favour of periarticular infiltration and had borderline statistical significance.

A total of 39 adverse events, of which 27 were serious, were reported in the femoral nerve block group compared with 51 adverse events, of which 38 were serious, in the periarticular group up to six weeks post-operatively.

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