A Prospective Comparative Study of Post Total Knee Arthroplasty Pain Management by Epidural vs Local Infiltration.

ABSTRACT

In a randomized controlled trial, we compared whether local infiltration analgesia would result in better pain management after total knee arthroplasty (TKA) than epidural analgesia (EA). Two groups were made with 30 patients each. Group local infiltration analgesia (LIA) with a total of 30 patients (mean age of 65 years) received LIA with a periarticular injection of a mixture of ropivacaine, adrenaline, and ketorolac that was prepared under strict sterile conditions. In group EA, 30 patients (mean age of 67 years) were given EA. There was no statistically significant difference of pain at rest. The mean opioid consumption was higher in those receiving local infiltration. Most secondary outcomes were similar, but EA patients had lower pain scores when walking and during continuous passive movement. If EA is not readily available, local infiltration provides similar length of stay and similar pain scores at rest following TKA.