Abstract: Objectives: Post-operative pain management in Total Knee Arthroplasty (TKA) remains a challenging issue even though it is a commonly performed procedure today. Majority of the patients report severe pain following surgery due to which mobilization and early rehabilitation is hampered. Therefore, appropriate pain management is the need of the hour and Local Infiltration Analgesia (LIA) using periarticular cocktail injection is one of the preferred techniques. The objective of this study was to assess the functional outcome and patient satisfaction after using LIA in the form of periarticular Ranawat-cocktail among post-TKA patients.
Materials and Methods: This study was conducted at SGITO, Bangalore during the period between August 2017 to April 2018. In this study, we used LIA consisting of the Ranawat Regimen for TKA patients which contains (bupivacaine with adrenaline, morphine, methylprednisolone, cefazoline and normal saline) to manage postoperative pain in all 53 patients presenting to our institute for primary TKA. Functional outcome was assessed in terms of post-op VAS score, ROM, and SLRT at 12hrs, 24hrs, and 48hrs post-op. Opioid consumption, and patient satisfaction was recorded and statistical analysis was done.
Results: The mean age of patients in the study was 60.83. Mean VAS pain score at 12hrs, 24hrs, and 48hrs post-op were found to be 5, 3.5 and 2.79 respectively which indicated a highly significant (p<0.001) reduction in pain following TKA. Majority of the patients (71.7%) did not require any opioid rescue analgesia. Post-op ROM was satisfactory and all patients were able to do SLRT by day 1 and there was excellent patient satisfaction at time of discharge.
Conclusion: Local Infiltration Analgesia is a safe, simple and efficient method of reducing post-operative pain after total knee arthroplasty (TKA) which facilitates early rehabilitation among the patients and has an overall improvement in patient satisfaction with the procedure.
