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Effect of local anaesthetic wound infiltration on acute pain and bleeding after primary total hip arthroplasty: the EDIPO randomised controlled study

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Abstract

Purpose

Total hip arthroplasty (THA) is considered a painful procedure with significant blood loss. The aim of the this study was to determine whether local infiltration analgaesia (LIA) (with long-acting local anaesthetics and epinephrine) during THA could reduce acute postoperative pain, improve early recovery and reduce per- and postoperative bleeding.

Methods

One hundred and fifty patients scheduled for primary THA were randomised into two groups. The treatment group received LIA (ropivacaine with epinephrine), whereas the control group had no infiltration. Pain intensity was measured with a visual analogue scale (VAS) for the duration of hospital stay and analgaesic consumption. Length of hospital stay, time to get out of bed alone and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index at 3, 6 and 12 months were recorded to evaluate recovery. Per- and postoperative bleeding were evaluated using direct and indirect criteria (operative blood loss, haemoglobin, estimation of uncompensated blood loss and red blood cell transfusion).

Results

Patients with LIA had significantly less pain during the first 24 h (p = 0.04). No significant differences were found in terms of analgaesic consumption (p = 0.57), early and delayed recovery or bleeding between groups.

Conclusions

Operative wound infiltration of LIA reduced acute pain after primary THA but did not improve recovery or influence per- and postoperative bleeding.

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Acknowledgments

Acknowledgements to Myriam Galvin (Clinical Research Assistant) and Lydie Benmadid (nurse and former English teacher).

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Authors and Affiliations

  1. Department of Orthopedics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France

    Guillaume Villatte, Emilien Engels, Roger Erivan, Nicolas Caumon, Stéphane Boisgard & Stéphane Descamps

  2. Laboratory C-Biosenss EA 4676, Clermont-Ferrand University, Université d’Auvergne, 63000, Clermont-Ferrand, France

    Guillaume Villatte & Stéphane Descamps

  3. Department of Biostatistics, Clermont-Ferrand University Hospital, 58 rue Montalembert, 63000, Clermont-Ferrand, France

    Aurélien Mulliez

Authors
  1. Guillaume Villatte
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  2. Emilien Engels
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  3. Roger Erivan
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  4. Aurélien Mulliez
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  5. Nicolas Caumon
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  7. Stéphane Descamps
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Correspondence to Guillaume Villatte.

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The authors declare no conflict of interest with this study.

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Villatte, G., Engels, E., Erivan, R. et al. Effect of local anaesthetic wound infiltration on acute pain and bleeding after primary total hip arthroplasty: the EDIPO randomised controlled study. International Orthopaedics (SICOT) 40, 2255–2260 (2016). https://doi.org/10.1007/s00264-016-3133-3

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  • DOI: https://doi.org/10.1007/s00264-016-3133-3

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