Periarticular infiltration appears to be a superior method of pain control during knee arthroplasty compared with femoral nerve block, according to one of the last projects of a leading orthopaedic surgeon.
The research on pain control instigated by the late Andrew Sprowson has been published this month, two years after his death.
He had set up a randomised control trial of the two treatments in Coventry.
More than 250 patients took part in the research, now reported in The Bone and Joint Journal.
Periarticular infiltration involves injecting anaesthetic agents around the knee joint and can be performed by a surgeon without specialist equipment.
The researchers report that patients who received infiltration had less need of pain-killers following surgery, reducing the need for morphine.
They say the new treatment saved time and resources while improving patient care.
Peter Wall, a clinical lecturer at the University Hospitals Coventry and Warwickshire, said: “I want to emphasise the debt we owe to our late colleague Andrew Sprowson. Without his initiative and enthusiasm, this research study would not have taken place.”
He added: “Our study has demonstrated the advantages of injections of anaesthetic agents around the knee during knee replacement surgery over other methods. These injections are now shown to be safe and effective. They also involve fewer resources and reduce the need for powerful painkillers such as morphine.
“This is to be welcomed as the potential risks of morphine-type pain relief are well known and should be avoided where possible. We hope that these study findings, if put into practice, will benefit patients around the world."
A pragmatic randomised controlled trial comparing the efficacy of a femoral nerve block and periarticular infiltration for early pain relief following total knee arthroplasty. The Bone and Joint Journal July 2017; doi: 10.1302/0301-620X.99B7.BJJ-2016-0767.R2 [abstract]
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