A study published in the Nov. 1 issue of The Journal of Bone & Joint Surgery compares the use of peripheral nerve blockade (PNB) against two variations of periarticular infiltration (PAI) as part of a multimodal analgesia pathway for total hip arthroplasty (THA). 

The authors conducted a randomized clinical trial of 159 patients who underwent THA and who received either PNB (n = 51), PAI with ropivacaine, ketorolac, and epinephrine (PAI-R; n = 54), or PAI with liposomal bupivacaine, ketorolac, and epinephrine (PAI-L; n = 54). They found that opioid consumption was low and did not differ across cohorts at any time interval. However, based on a 1-10 ascending numeric rating scale, median maximum pain on postoperative day 1 was 5.0 in the PNB group, 5.5 in the PAI-R group, and 4.0 in the PAI-L. On postoperative day 2, median maximum pain was 3.5 for the PNB group, 5.0 for the PAI-R group, and 3.5 for the PAI-L group. The authors write that the PAI-L group was not significantly different from the PNB group with respect to any outcomes: postoperative opioid use, length of stay, hospital adverse events, and 3-month follow-up data including any complication. Learn more...

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