Efficacy of intraoperative periarticular injection versus post-operative epidural analgesia in total hip arthroplasty: A randomised control study
Jithin Mohan, Shikhar Yadav, Dileep S Nair, Syam Gangadharan Nair, Tigy Thomas Jacob, John Thayyil John
Background: Total Hip Arthroplasty is the most common surgery done for various arthritic conditions of the hip. Early mobilisation is the key factor for a successful rehabilitation after it. Management of post-operative pain thus has become a pivotal role after hip arthroplasty. Intraoperative periarticular injection has shown superior results in the case of Total Knee Arthroplasty . The present study aimed at comparing the efficacy of intraoperative periarticular injection with cocktail in Total Hip Arthroplasty with commonly used post-operative epidural infusion.
Methods: A Randomised control study was done in 48 subjects grouped into two. Periarticular injection (PAI) group received intraoperative periarticular injection cocktail and epidural infusion (EA) group received post-operative epidural infusion. Outcomes were measured in terms of Visual Analogue Score (VAS) for pain at rest and activity in 0-24 hrs, 24-48 hrs, 48-72 hrs, along with the distance walked by the patient on the second and third post-operative day. The number of days taken by each patient to walk 100 meters at a stretch was also compared. For the secondary outcomes the side effects and need for rescue analgesia in both the groups were measured.
Results: VAS for pain was less in PAI group both in rest and activity which was statistically significant. The functional outcome was better in PAI group compared to EA. Need for rescue analgesia was less in PAI, but the side effects in both groups showed no statistical significance.
Conclusion: The intraoperative periarticular injection in Total Hip Arthroplasty is superior to the post-operative continuous infusion of epidural analgesia.
Jithin Mohan, Shikhar Yadav, Dileep S Nair, Syam Gangadharan Nair, Tigy Thomas Jacob, John Thayyil John. Efficacy of intraoperative periarticular injection versus post-operative epidural analgesia in total hip arthroplasty: A randomised control study. International Journal of Orthopaedics Research, Volume 2, Issue 4, 2020, Pages 64-67