PROSPECTIVE STUDY OF EFFICACY OF LOCAL INFILTRATION ANALGESIA AND EPIDURAL ANALGESIA IN PATIENTS UNDERGOING TOTAL KNEE REPLACEMENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 41
Abstract
BACKGROUND Aims- Multiple studies have been done regarding post-operative analgesia after knee surgeries including intravenous opioids, epidural analgesia and nerve blocks. Hence, we compared the efficacy of Local Infiltration Analgesia (LIA) technique over Epidural Analgesia (EA) technique in patients undergoing TKR surgeries. MATERIALS AND METHODS 72 patients of either sex, aged > 50 years, belonging to ASA I to III, posted for unilateral TKR for varus deformity were randomised into two groups. Patients in Group 1 received LIA and Group 2 EA. Parameters assessed were: Pain on VAS scale, Range of Movements (ROM), ambulation with support, patient satisfaction at 6 hrs., 24 hrs., 48 hrs., 72 hrs. and 96 hrs. Post-operatively. RESULTS Statistical analysis of the univariate and multivariate factors was performed using paired ‘t’, Chi-square test, Fisher’s test as applicable. The pain was significantly more in LIA group than in EA group at 6 hrs., 24 hrs., 48 hrs., 72 hrs. and 96 hrs. intervals. The ROM was significantly observed more in LIA group than in EA group at 48 hrs. and 72 hrs. However, there was no significant difference at 96 hrs. between both groups. Ambulation with support was possible only in LIA group. Rescue analgesia was needed only in LIA group (13.9% vs 0%). Patients of EA group were more satisfied at the end of 4 days (86.1% vs 69.4%). CONCLUSION Local infiltration analgesia provides simple, safe comparable analgesic efficacy and earlier ambulation than epidural analgesia post-operatively after total knee replacement surgery.
Authors and Affiliations
Manjunath Y Hanjagi, Prasad Varkey, Prakash V
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