Arthroplasty Complications, Pain, Post Operative
Conditions
Keywords
total hip arthroplasty, transarticular multimodal drug infiltration, periarticular multimodal drug infiltration
Brief summary
This research aim to improve postoperative outcome in total hip arthroplasty(THA) by using local mixture infiltration as bupivacaine + NSAID + epinephrine + tranxemic acid. In the present time these mixture components has shown to improve THA outcome by aspect of postoperative pain control, postoperative opioid consumption, postoperative bleeding, LOS and postoperative rehabilitation without increasing complication but the accuracy of infiltration technique which gives the best outcome has not been yet discovered.Recently study by Hashimoto et al has risen that these technique can be administrated by both periarticular and intra-articular approach.By considering the complexity of human anatomy around the hip tissue we assume that the intra-articular(transarticular) may given equivalence (may be better) outcome with lowering procedural related complication comparing to periarticular infiltration approach.
Interventions
PROCEDUREtransarticular multimodal drug infiltration
as described previously
Sponsors
Department of Medical Services Ministry of Public Health of Thailand
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
45 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* patient who would go on cemented and cementless THA * age 45-60 years of age * voluntary decision
Exclusion criteria
* bilateral THA * revision surgery * history of pelvic and hip surgery previously * allergy to medication in protocol * CKD stage 4-5, chronic liver disease with Child Pugh B or C * pregnancy * history of hip injection * U/D * hypercoagulable state * abnormal laboratory coagulation study as INR \> 1.4 or aPTT \> 1.4 * abnormal platelet function * thrombocytopenia * PE , DVT, ischemic stroke, CAD/ischemic heart disease * use of anticoagulant or hormonal usage * anesthesia by general anesthesia or additional nerve block * can not understand PCA usage * use postopertive wound drainage
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Visual analogue scale at rest on postoperative day1st and 2nd | 1 week |
Secondary
| Measure | Time frame |
|---|---|
| total morphine consumption in first 24 hours postoperative period via PCA pump | 1 week |
| total morphine consumption in whole postoperative period | 1 week |
| length of stay | 1 week |
| postoperative complication | 1 week |
Countries
Thailand
Outcome results
None listed