A Randomized Controlled Trial of Intra-articular Ropivacaine for Pain Management Immediately Following Total Knee Arthroplasty

Adam S. Rosen, DO
Division of Orthopaedic Surgery, Scripps Clinic

Clifford W. Colwell Jr., MD
Division of Orthopaedic Surgery, Scripps Clinic

Pamela A. Pulido, BSN
Shiley Center for Orthopaedic Research and Education at Scripps Clinic, Scripps Health

Tricia L. Chaffee, RN
Division of Orthopaedic Surgery, Scripps Clinic

Steven N. Copp, MD
Division of Orthopaedic Surgery, Scripps Clinic

Abstract

Total knee arthroplasty (TKA) is a commonly performed procedure for the treatment of end-stage arthritis of the knee. Pain control following TKA is difficult to manage in some patients. We examined the use of a postoperative intra-articular injection of 100 mL of 0.2% (200 mg) ropivacaine in a double-blind, prospective, placebo-controlled pilot study to evaluate its use as a pain control modality. All patients received general anesthesia. Postoperatively, patients were placed on intravenous patient-controlled analgesia with morphine. The ropivacaine group showed an early trend in lower visual analog scale (VAS) scores when compared with the placebo group. Patients receiving ropivacaine used a similar amount of narcotics compared with the placebo group. Intra-articular ropivacaine used for pain control after TKA demonstrated no statistically significant difference in lowering VAS scores or narcotic usage; therefore, intra-articular ropivacaine as a single modality is not recommended for effective pain management.

This article appears in HSS Journal: Volume 6, Number 2.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

 

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