Analgesia for Total Knee Arthroplasty: A Randomized Controlled Study Comparing Local Infusion Analgesia, Femoral Nerve Block and Intrathecal Morphine

Johnathan D. Craik, Jason G. Koerber, Jegan Krishnan, Chris Wilson

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: The aim of this study was to compare the effectiveness of continuous intra-articular local infiltration analgesia,
femoral nerve block and intrathecal morphine for the management of post-operative pain and early function following total knee arthroplasty.
Methods: A single center, three-armed parallel group, double blinded, randomized controlled pilot trial was undertaken. Patients were randomized to receive either local infiltration analgesia, femoral nerve block or intrathecal morphine for post-operative analgesia following total knee arthroplasty. The efficacy of analgesia was determined by recording post-operative pain visual analogue scores, opiate requirements and side effects, and functional scores at 24 hours, 48 hours, and 6 weeks post-operatively.
Results: 45 patients were recruited to the study. 4 were excluded due to voluntary withdrawal and incomplete follow-up. The final analysis included 13 patients randomized to the local infiltration analgesia group, 14 patients to the femoral nerve block group and 14 patients to the intrathecal morphine group. There were no significant differences in post-operative pain scores, opiate requirements and associated side effects, or functional scores at any point during the study period.
Conclusion: This study did not identify any significant differences between continuous intra-articular local infiltration analgesia, femoral nerve block and intrathecal morphine for delivering post-operative an-algesia following total knee arthroplasty.
KEYWORDS: Knee; Arthroplasty; Analgesia; Local; Regional; Intrathecal
ABBREVIATIONS: TKA: Total Knee Arthroplasty; LIA: Local Infusion Analgesia; FNB: Femoral Nerve Block; IM: Intrathecal Morphine; IV: Intravenous; TUG: Timed Up and Go (test); OKS: Oxford Knee Score; KSS: Knee Society Score; PRN: Pro Re Nata; PCA: Patient Controlled Analgesia; APS: Acute Pain Service; BMI: Body Mass Index
Original languageEnglish
Pages (from-to)1600-1605
Number of pages6
JournalOpen Access Journal of Biomedical Science
Volume4
Issue number1
DOIs
Publication statusPublished - Jan 2022

Keywords

  • Knee
  • Arthroplasty
  • Analgesia
  • Local
  • Regional
  • Intrathecal

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