A new method for pain management in total knee arthroplasty: Intraoperative local anesthetic application in addition to one‑shot femoral block

Abstract

Background and Aim: Total knee arthroplasty (TKA) is an effective treatment for end‑stage knee arthritis, but the optimal management of postoperative pain remains controversial. Therefore, this study investigated the efficacy of different local anesthetic application methods on early, 1st day pain control after TKA. Methods: A total of 200 patients who underwent unilateral TKA surgery with spinal anesthesia were randomly assigned into four different groups (50 in each) and were administered pain control by different peri‑and post‑operative regimens. Group A was the control group wherein no postsurgical analgesia was administered to assess spinal anesthesia efficacy; in Group B, only postsurgical one‑shot femoral block was applied; in Group C, intraoperative periarticular local anesthetic was applied; in Group D, a combination of the one‑shot femoral block and intraoperative periarticular local anesthetics were applied. Results: Group D patients experienced significantly better postoperative pain relief (P < 0.05) and were therefore more relaxed in pain and knee flexion than the other patient groups. Conclusion: The intraoperative periarticular application of local anesthetics in addition to one‑shot femoral block is an efficient way of controlling postsurgical pain after TKA.