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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 Oct 04

DOI: 10.23736/S0375-9393.17.12110-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The addition of continuous wound infusion of local anaesthetics to local infiltration in the management of postoperative pain and rehabilitation after total hip arthroplasty: a double-blind randomized controlled trial

Pierfrancesco FUSCO 1, Vincenza COFINI 2, Emiliano PETRUCCI 1 , Paolo SCIMIA 2, Maurizio FIORENZI 2, Giuseppe PALADINI 3, Astrid U. BEHR 4, Battista BORGHI 5, Stefano FLAMINI 6, Renzo PIZZOFERRATO 7, Olivo COLAFARINA 6, Alexander DI FRANCESCO 6, Tito TABACCO 6, Stefano NECOZIONE 2, Franco MARINANGELI 2

1 Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L'Aquila, L’Aquila, Italy; 2 Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy; 3 Department of Anesthesia and Intensive Care Unit, University of Chieti-Pescara, Chieti, Italy; 4 Department of Anesthesia and Intensive Care Unit, Hospital of Padua, University of Padua, Padua, Italy; 5 Department of Anesthesiology Research Unit, IRCCS Orthopaedic Institute Rizzoli, Bologna, Italy; 6 Department of Orthopedic Surgery and Trauma, San Salvatore Academic Hospital of L'Aquila, L’Aquila, Italy


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BACKGROUND: Total hip arthroplasty is one of the most common procedures in orthopaedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anaesthetics in the first 72 h after surgery could provide more effective postoperative analgesia with better rehabilitation.
METHODS: A double-blind, randomized, controlled study was conducted with 96 patients who underwent total hip arthroplasty. The patients were randomized to receive either a local infiltration analgesia and continuous wound infusion of anaesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anaesthesia and a local infiltration analgesia. A multihole catheter was placed next to the implant and connected to an electronic pump containing a 300 ml solution of 0.2% levobupivacaine (experimental group) or saline (control group).
RESULTS: A total of 96 consecutive patients were enrolled and randomized. Of these, 48 patients received local infiltration analgesia and continuous wound infusion of local anaesthetics, and the remainder received local infiltration analgesia and continuous wound infusion of saline solution. The analysis showed a significant main effect of treatment on the postoperative incident of pain [Ftreatment (1,93)=22.62, p=0.000] and on resting pain during the post-surgery follow-up [Ftreatment (1, 93)=15.62, p=0.0002]. The pain scores during the rehabilitation period were significantly less in the experimental group. Analgesic consumption was less in the experimental group.
CONCLUSIONS: The addition of continuous wound infusion of anaesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.


KEY WORDS: Analgesia - Postoperative period - Continuous wound infusion - Local anaesthetics infiltration - Total hip arthroplasty

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Publication History

Article first published online: October 04, 2017
Manuscript accepted: September 26, 2017
Manuscript revised: September 12, 2017
Manuscript received: March 28, 2017

Cite this article as

Fusco P, Cofini V, Petrucci E, Scimia P, Fiorenzi M, Paladini G, et al. The addition of continuous wound infusion of local anaesthetics to local infiltration in the management of postoperative pain and rehabilitation after total hip arthroplasty: a double-blind randomized controlled trial. Minerva Anestesiol 2017 Oct 04. DOI: 10.23736/S0375-9393.17.12110-3

Corresponding author e-mail

petrucciemiliano@gmail.com