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Assessment of Intraoperative Periarticular Cocktail Injection in Patients Undergoing Total Knee Replacement
Keywords:
Total Knee Replacement, Osteoarthritis, Intra-Operative Periarticular Cocktail Injection, Pain Score.Abstract
Objective: Determine the average pain score after intraoperative periarticular cocktail injection in patients who have undergone total knee arthroplasty.
Background: Osteoarthritis of the knee is one of the most common and debilitating diseases in the world, affecting the quality of life of patients (QoL). Managing pain after a total knee replacement (TKR) is essential for post-operative rehabilitation. The use of epidural analgesics or parenteral opioids can lead to unwanted side effects that impede early recovery and rehabilitation. These side effects can be prevented by infiltrating a local pain reliever cocktail.
Objective: Determine the average pain score after intraoperative periarticular cocktail injection in patients who have undergone total knee arthroplasty.
Methodology: This descriptive case series study was conducted at orthopedics department from October 26, 2020, to April 27, 2021. In total, 124 patients with total knee replacement surgery were registered in this study. All surgeries and cocktail injections were carried out by one surgeon using a medial parapatellar arthrotomy. A cocktail consisted of 90ml normal saline mixed with 17.5 ml of bupivacaine (5%), 30 mg of ketorolac (2ml solution) and 0.5 ml of adrenaline was injected into the knee joint in all patients included in the study. Post-operative pain was recorded by the nurse with a 10-point Visual Analogue Scale (VAS) at 6 and 48 hours after surgery. All entries were processed using SPSS v25.0. The data were stratified by age, gender and BMI to process effect modifiers. An independent t-test was used after stratification. The p-value of 0.05 was found to be significant.
Results: The result of the study showed statistically decrease in pain score. The mean pain score after 6 hours was 5.17±1.03 that reduced to 2.93±1.11 after 48 hours.
Conclusion Based on the results it can be concluded that the intraoperative periarticular cocktail injection is an effective treatment in reducing pain in patients undergoing total knee arthroplasty.
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