How effective is periarticular drug infiltration in providing pain relief and early functional outcome following total hip arthroplasty?

Abstract The aim of the study was to compare the efficacy of periarticular injection of a cocktail of analgesic drugs (PIC) with epidural infiltration (EA), in providing postoperative pain relief and early functional improvement following Total Hip Arthroplasty (THA). Methods 50 patients undergoing...

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Bibliographic Details
Published in:Journal of clinical orthopaedics and trauma 2019-05, Vol.10 (3), p.550-554
Main Authors: Srampickal, George Mathew, Jacob, Korula Mani, Kandoth, Jacob Joe, Yadev, Bijesh Kumar, Palraj, Tyagraj, Oommen, Anil Thomas, George, Sajan Philip, Poonnoose, Pradeep Mathew
Format: Article
Language:English
Subjects:
ARTHROPLASTY
Cocktail
Epidural infiltration
Orthopedics
Pain
Periarticular injection
THR
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Summary:Abstract The aim of the study was to compare the efficacy of periarticular injection of a cocktail of analgesic drugs (PIC) with epidural infiltration (EA), in providing postoperative pain relief and early functional improvement following Total Hip Arthroplasty (THA). Methods 50 patients undergoing unilateral THA were randomized to receive either EA or PIC for postoperative pain control. Postoperative pain relief, as determined by the visual analogue scale (VAS), functional recovery and side effects related to EA and PIC were assessed. Results PIC resulted in significantly lower VAS scores [0.48(0.71) vs 3.04(2.07)] in the first 24 h after surgery [mean (SD)], when compared to EA. The pain relief continued to be significantly lower even on the 10th postoperative day. Functional recovery was significantly better in the PIC group, with patients being able to walk longer distances and climb steps more quickly following THA. EA, unlike PIC was associated with side effects like nausea, vomiting, motor weakness, back pain and urinary retention. The overall satisfaction rate with treatment was significantly better in PIC group (9.04/10) than those who received EA (7.76/10). Conclusion PIC provides significantly better pain control and functional recovery in the early postoperative period, with less side effects when compared with EA. PIC should be the choice for pain control following THA.
ISSN:0976-5662
2213-3445
DOI:10.1016/j.jcot.2018.06.005