PMID- 36856569
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230623
IS  - 1745-3682 (Electronic)
IS  - 1745-3674 (Print)
IS  - 1745-3674 (Linking)
VI  - 94
DP  - 2023 Feb 28
TI  - Efficacy of epinephrine in local infiltration analgesia on pain relief and opioid 
      consumption following total knee arthroplasty: a randomized controlled trial.
PG  - 97-101
LID - 10.2340/17453674.2023.8482 [doi]
AB  - BACKGROUND AND PURPOSE: Local infiltration analgesia (LIA) is one of the 
      effective regimens to reduce pain after total knee arthroplasty (TKA). 
      Epinephrine is a commonly used sympathetic adjunct in LIA. It is expected to 
      enhance the intensity and extend the duration of LIA. The primary aim of the 
      study was to evaluate the efficacy of epinephrine on postoperative pain control 
      after primary TKA. PATIENTS AND METHODS: A total of 80 patients who underwent 
      primary TKA were randomized into an epinephrine (EN) and a control (C) group. 
      Postoperative visual analogue pain score (VAPS) and morphine consumption were 
      recorded every 6 hours until 48 hours after operation. The VAPS 6-48 hours were 
      compared using repeated measure statistics. The range of motion (ROM) on 
      discharge and complications were also compared between these 2 groups. RESULTS: 
      The study showed that although VAPS differed statistically between the 2 groups 
      at 12 hours (C higher) and 48 hours (C lower) postoperatively (p = 0.04 and 0.02, 
      respectively), repeated measures analysis revealed that there were no significant 
      differences in 6-48 hours VAPS (p = 0.6). Total morphine consumption in the EN 
      and C groups was 3.4 (SD 3.7) and 4.2 (SD 4.4) mg, respectively (p = 0.4). ROM on 
      discharge was also similar between the groups. No complications were detected in 
      this study. CONCLUSION: Our study showed that additional epinephrine in LIA had a 
      statistically significant reduction in VAPS at 12 hours and morphine usage during 
      6-12 hours when compared with the control group. However, the magnitude of 
      difference did not reach minimal clinically importance difference (MCID) value 
      for TKA.
FAU - Chareancholvanich, Keerati
AU  - Chareancholvanich K
AD  - Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Tantithawornwat, Suphawat
AU  - Tantithawornwat S
AD  - Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Ruangsomboon, Pakpoom
AU  - Ruangsomboon P
AD  - Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Narkbunnam, Rapeepat
AU  - Narkbunnam R
AD  - Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Chatmaitri, Swist
AU  - Chatmaitri S
AD  - Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Pornrattanamaneewong, Chaturong
AU  - Pornrattanamaneewong C
AD  - Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand. toonchaturong@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20230228
PL  - Sweden
TA  - Acta Orthop
JT  - Acta orthopaedica
JID - 101231512
RN  - 0 (Analgesics, Opioid)
RN  - 76I7G6D29C (Morphine)
RN  - YKH834O4BH (Epinephrine)
SB  - IM
CIN - Acta Orthop. 2023 Jun 16;94:. PMID: 37345309
MH  - Humans
MH  - Pain Management
MH  - Analgesics, Opioid
MH  - *Arthroplasty, Replacement, Knee
MH  - *Analgesia
MH  - Morphine
MH  - Pain, Postoperative
MH  - Epinephrine
PMC - PMC9976710
EDAT- 2023/03/02 06:00
MHDA- 2023/03/04 06:00
PMCR- 2023/02/28
CRDT- 2023/03/01 10:06
PHST- 2022/04/09 00:00 [received]
PHST- 2023/03/01 10:06 [entrez]
PHST- 2023/03/02 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2023/02/28 00:00 [pmc-release]
AID - ActaO-94-8482 [pii]
AID - 10.2340/17453674.2023.8482 [doi]
PST - epublish
SO  - Acta Orthop. 2023 Feb 28;94:97-101. doi: 10.2340/17453674.2023.8482.