A Randomized Controlled Trial of Intraarticular Ropivacaine for Pain Management Immediately Following Total Knee Arthroplasty
Total knee arthroplasty (TKA) is a commonly performed procedure for the treatment of end-stage arthritis of the knee. Pain control following TKA is difficult to manage in some patients. We examined the use of a postoperative intraarticular injection of 100 mL of 0.2% (200 mg) ropivacaine in a double-blind, prospective, placebo-controlled pilot study to evaluate its use as a pain control modality. All patients received general anesthesia. Postoperatively, patients were placed on intravenous patient-controlled analgesia with morphine. The ropivacaine group showed an early trend in lower visual analog scale (VAS) scores when compared with the placebo group. Patients receiving ropivacaine used a similar amount of narcotics compared with the placebo group. Intraarticular ropivacaine used for pain control after TKA demonstrated no statistically significant difference in lowering VAS scores or narcotic usage; therefore, intraarticular ropivacaine as a single modality is not recommended for effective pain management.
Keywordstotal knee arthroplasty ropivacaine intraarticular injection pain control randomized controlled trial
The authors would like to thank Julie C. McCauley, MPHc, for assistance with the statistical analysis and Mary E. Hardwick, MSN, for assistance in the preparation of this manuscript.
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