Periarticular Injection of Ketorolac Augmenting Intravenous Administration of Ketorolac for Postoperative Pain Control: A Randomized Controlled Trial in Simultaneous Bilateral Total Knee Arthroplasty
| Autor: | Manupat Lohitnavy, Piti Rattanaprichavej, Artit Laoruengthana, Krit Pongpirul, Thanawat Tantimethanon, Akaworn Mahatthanatrakul |
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| Rok vydání: | 2020 |
| Předmět: |
Randomization
Visual analogue scale Analgesic Total knee arthroplasty Injections Intra-Articular law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law Statistical significance medicine Humans Orthopedics and Sports Medicine Anesthetics Local Arthroplasty Replacement Knee Bupivacaine Analgesics Pain Postoperative 030222 orthopedics business.industry Analgesics Opioid body regions Ketorolac Anesthesia Administration Intravenous Surgery business medicine.drug |
| Zdroj: | The Journal of Knee Surgery. 35:868-873 |
| ISSN: | 1938-2480 1538-8506 |
| Popis: | Adequate postoperative pain control with minimal side effects is necessary for patients undergoing total knee arthroplasty (TKA). Ketorolac is a frequently used nonsteroidal anti-inflammatory drug due to its excellent disposition in all administration routes; however, it possesses an “analgesic ceiling,” which means that higher doses of the drug have no additional analgesic effect. Alternatively, increasing the local concentration of ketorolac via periarticular injection may provide additional pain relief to parenteral administration of ketorolac, but evidence demonstrating the benefits and safety of this approach is limited. Therefore, this study assesses whether local ketorolac injection could yield additional pain reduction to intravenous administration of ketorolac. A total of 54 patients who underwent simultaneous bilateral TKA were enrolled. Randomization was performed to determine whether 50 mg of bupivacaine plus 30 mg of ketorolac (ketorolac group), or only 50 mg bupivacaine (bupivacaine group) would be periarticularly injected into the first knee operated on (more painful), and then the contralateral knee would receive another mixture. Ketorolac (30 mg) was intravenously given every 8 hours for the first 48 hours. Visual analog scales (VASs) were used to assess pain, knee recovery function, and patients' preferred knee. Postoperative VAS pain scores in the ketorolac group were lower than those in the bupivacaine group 6 to 96 hours postoperatively and reached statistical significance 12 (4.25 ± 2.38 vs. 5.06 ± 2.48, respectively; p = 0.04) and 24 hours (4.22 ± 1.94 vs. 5.30 ± 2.12, respectively; p |
| Databáze: | OpenAIRE |
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