Osteoarthritis, Hip
Conditions
Keywords
Arthroplasty, Replacement, Hip, Anesthesia, Local, Ropivacaine, Randomized controlled trial
Brief summary
Background: The Local infiltration analgesic (LIA) technique has been widely used to reduce opioid requirements and improve the patient's mobilization after total hip arthroplasty (THA). However, the evidence for LIA in THA remains to be clarified. Purpose: To evaluate whether a single shot LIA in addition to a multimodal analgesic regimen reduces acute postoperative pain and opioid requirements after THA.
Interventions
PROCEDURElocal infiltration anesthesia using Ropivacaine and Epinephrine
150 ml Ropivacaine 2mg/ml + 0,5 ml Epinephrine 1 mg/ml: The first 50 ml will be injected in the periacetabular tissue after insertion of the acetabular component. After insertion of the femoral component, 50 ml will be inserted in the gluteus muscles and the proximal part of the iliotibial tract. The last 50 ml will be inserted in the subcutaneous layer.
PROCEDURElocal infiltration anesthesia using saline
150 ml 0,9% saline: The first 50 ml will be injected in the periacetabular tissue after insertion of the acetabular component. After insertion of the femoral component, 50 ml will be inserted in the gluteus muscles and the proximal part of the iliotibial tract. The last 50 ml will be inserted in the subcutaneous layer.
PROCEDUREMultimodal analgesic regimen
All patients will be operated under spinal anaesthesia with 2.0-3.0 ml Bupivacaine 0.5 % plain, preferably at the L2/L3 alternatively the L3/L4 vertebral interspace. Propofol infusion will be administrated for sedation if needed. Postoperative morphine will be given as needed intravenously when needed. After transfer to a specialized hip arthroplasty unit with a well-defined and experienced program for multimodal rehabilitation, multimodal oral opioid-sparing analgesia will be given to all patients; NSAIDS and Acetaminophen will be given at regular intervals and Oxycodone as needed.
Sponsors
St. Olavs Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* all patients receiving total hip arthroplasty in the study period
Exclusion criteria
* contraindications to receive spinal anesthetic, Dexamethasone or Acetaminophen. * Patients who received general anaesthetic * patients who will get a different operation than standard direct lateral surgery * Patients with osteosynthesis to be removed in the same operation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain assessed by numeric rating scale | 1 day (first postoperative day) | assessed by numeric rating scale |
Countries
Norway
Outcome results
None listed