Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty

Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Maurizio Fiorenzi, Giuseppe Paladini, Astrid U Behr, Battista Borghi, Stefano Flamini, Renzo Pizzoferrato, Olivo Colafarina, Alexander Di Francesco, Tito Tabacco, Stefano Necozione, Franco Marinangeli

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours 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 anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia 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 anesthetics, 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 (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(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 anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.

Original languageEnglish
Pages (from-to)556-564
Number of pages9
JournalMinerva Anestesiologica
Volume84
Issue number5
DOIs
Publication statusPublished - May 2018

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Postoperative Pain
Arthroplasty
Analgesia
Hip
Rehabilitation
Wounds and Injuries
Local Anesthetics
Sodium Chloride
Analgesics
Anesthetics
Pain
Local Anesthesia
Orthopedics
Catheters
Control Groups

Keywords

  • Analgesia
  • Postoperative period
  • Intra-arterial infusions
  • Local anesthesia
  • Hip replacement arthroplasty

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Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty. / Fusco, Pierfrancesco; Cofini, Vincenza; Petrucci, Emiliano; Scimia, Paolo; Fiorenzi, Maurizio; Paladini, Giuseppe; Behr, Astrid U; Borghi, Battista; Flamini, Stefano; Pizzoferrato, Renzo; Colafarina, Olivo; Di Francesco, Alexander; Tabacco, Tito; Necozione, Stefano; Marinangeli, Franco.

In: Minerva Anestesiologica, Vol. 84, No. 5, 05.2018, p. 556-564.

Research output: Contribution to journalArticle

Fusco, P, Cofini, V, Petrucci, E, Scimia, P, Fiorenzi, M, Paladini, G, Behr, AU, Borghi, B, Flamini, S, Pizzoferrato, R, Colafarina, O, Di Francesco, A, Tabacco, T, Necozione, S & Marinangeli, F 2018, 'Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty', Minerva Anestesiologica, vol. 84, no. 5, pp. 556-564. https://doi.org/10.23736/S0375-9393.17.12110-3
Fusco, Pierfrancesco ; Cofini, Vincenza ; Petrucci, Emiliano ; Scimia, Paolo ; Fiorenzi, Maurizio ; Paladini, Giuseppe ; Behr, Astrid U ; Borghi, Battista ; Flamini, Stefano ; Pizzoferrato, Renzo ; Colafarina, Olivo ; Di Francesco, Alexander ; Tabacco, Tito ; Necozione, Stefano ; Marinangeli, Franco. / Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty. In: Minerva Anestesiologica. 2018 ; Vol. 84, No. 5. pp. 556-564.
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T1 - Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty

AU - Fusco, Pierfrancesco

AU - Cofini, Vincenza

AU - Petrucci, Emiliano

AU - Scimia, Paolo

AU - Fiorenzi, Maurizio

AU - Paladini, Giuseppe

AU - Behr, Astrid U

AU - Borghi, Battista

AU - Flamini, Stefano

AU - Pizzoferrato, Renzo

AU - Colafarina, Olivo

AU - Di Francesco, Alexander

AU - Tabacco, Tito

AU - Necozione, Stefano

AU - Marinangeli, Franco

PY - 2018/5

Y1 - 2018/5

N2 - BACKGROUND: Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours 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 anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia 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 anesthetics, 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 (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(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 anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.

AB - BACKGROUND: Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours 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 anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia 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 anesthetics, 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 (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(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 anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.

KW - Analgesia

KW - Postoperative period

KW - Intra-arterial infusions

KW - Local anesthesia

KW - Hip replacement arthroplasty

U2 - 10.23736/S0375-9393.17.12110-3

DO - 10.23736/S0375-9393.17.12110-3

M3 - Article

C2 - 28984095

VL - 84

SP - 556

EP - 564

JO - Minerva Anestesiologica

JF - Minerva Anestesiologica

SN - 0375-9393

IS - 5

ER -