American journal of translational research · 2025
The impact of ropivacaine local infiltration in multimodal analgesia on early functional recovery and safety in elderly patients undergoing total knee arthroplasty.
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Wang Qingyu, Chen Mingjie, Li Xie, Sun Yingui
Аннотация
OBJECTIVE: To investigate whether adding ropivacaine local infiltration (RLI) to standard analgesia can improve functional recovery outcomes and safety in elderly patients undergoing total knee arthroplasty (TKA).
METHODS: This retrospective study included 227 elderly patients who underwent unilateral TKA under spinal anesthesia between January 2023 and January 2025. According to different analgesic regimens, patients were divided into two groups: the conventional multimodal analgesia (CMA) group (n=105) and the RLI group (n=122). The cumulative use of morphine within 48 hours after surgery, visual analog scale (VAS) pain levels during activity, range of motion (ROM) of the knee joint, 6-minute walking distance, functional independence measurement (FIM) score, and incidence of adverse events were compared between the two groups.
RESULTS: At 24 and 48 hours postoperatively, cumulative morphine use was significantly lower in the RLI group compared with the CMA groups (all P<0.05). Activity-related VAS pain scores were significantly lower in the RLI group at all evaluation time points (all P<0.05). In addition, the RLI group demonstrated greater knee ROM (48-hours: 95.84 vs. 92.16, P<0.001), longer six-minute walk distances (48-hours: 213.29 vs. 204.85, P=0.007), and higher FIM motor scores (57.05 vs. 54.49, P=0.008), compared with the CMA group. Patients in the RLI group had a lower incidence of itching and a relatively shorter hospital stay.
CONCLUSION: In elderly patients undergoing TKA, local infiltration analgesia (LIA) can alleviate early postoperative pain, reduce the use of opioid drugs, and promote faster functional recovery.
METHODS: This retrospective study included 227 elderly patients who underwent unilateral TKA under spinal anesthesia between January 2023 and January 2025. According to different analgesic regimens, patients were divided into two groups: the conventional multimodal analgesia (CMA) group (n=105) and the RLI group (n=122). The cumulative use of morphine within 48 hours after surgery, visual analog scale (VAS) pain levels during activity, range of motion (ROM) of the knee joint, 6-minute walking distance, functional independence measurement (FIM) score, and incidence of adverse events were compared between the two groups.
RESULTS: At 24 and 48 hours postoperatively, cumulative morphine use was significantly lower in the RLI group compared with the CMA groups (all P<0.05). Activity-related VAS pain scores were significantly lower in the RLI group at all evaluation time points (all P<0.05). In addition, the RLI group demonstrated greater knee ROM (48-hours: 95.84 vs. 92.16, P<0.001), longer six-minute walk distances (48-hours: 213.29 vs. 204.85, P=0.007), and higher FIM motor scores (57.05 vs. 54.49, P=0.008), compared with the CMA group. Patients in the RLI group had a lower incidence of itching and a relatively shorter hospital stay.
CONCLUSION: In elderly patients undergoing TKA, local infiltration analgesia (LIA) can alleviate early postoperative pain, reduce the use of opioid drugs, and promote faster functional recovery.