A neuro-anatomically grounded scheme for LIA gives superior analgesia and comfort levels compared to epidural analgesia until seven days after total knee arthroplasty


Local infiltration analgesia ; patient controlled epidural analgesia ; total knee arthroplasty

Published online: Apr 16 2021

Alain F. Kalmar, Philippe Van Overschelde, Pieter Byn, Seth Pennynck, Henk Vanoverschelde

From the Department of Anesthesia and Intensive Care Medicine, Maria Middelares Hospital, Ghent, Belgium


LIA is an emerging alternative for patient-con- trolled epidural analgesia(PCEA) after total knee arthroplasty(TKA). LIA allows faster mobilisation, eliminates the risks of epidural catheters, and can hasten patient turnover. Conversely, PCEA provides reliable pain relief in the first days after this type of surgery. The purpose of this study was to evaluate the quality of antinociception, postoperative nausea & vomiting (PONV), and general comfort until 7 days postoperatively.

40 patients received PCEA and 41 received LIA. Patients were retrospectively asked for pain scores at the day of surgery(=D0), D2, and D7, PONV, and general comfort scores.

Patients in the LIA group reported equal pain scores at D0, significantly better PONV scores and pain scores at D2 and D7.

In addition to faster mobilisation and elimination of the risks and burden of an epidural catheter and PCEA, LIA delivers equal to better analgesia, and better PONV and general comfort scores.