Abstract
Purpose: To examine the hypothesis that continuous low-dose infiltration of a local anesthetic into the postoperative wound incision for a 48-hour period will diminish the need for narcotics or other analgesic, lower postoperative pain, and may further enhance recovery by eliminating adverse events associated with narcotic usage.
Methods: Forty-six patients prospectively randomized into blinded studies compared the new technique of continuous infiltration of bupivacaine (a local anesthetic) with placebo via an elastometric pump catheter. Parameters measured included pain and pain relief visual analog scale (VAS), narcotic consumption, and complications.
Findings: Results demonstrated bupivacaine groups in both studies used fewer narcotics; this was statistically significant (P = 0.03) in the TKA study. Pain scores were significantly lower and pain relief scores higher in the ACL group using bupivacaine. There were no adverse events.
Conclusion: Continuous infiltration of bupivacaine is a safe and effective method of improving postoperative pain management in ACL reconstruction and TKA surgery.