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The safety of peri-articular local anaesthetic injection for patients undergoing total knee replacement with autologous blood transfusion
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Wallace, D. F., Emmett, S. R., Kang, K. K., Chahal, G. S., Hiskens, Richard, Balasubramanian, Sabapathy P., McGuinness, Katie R., Parsons, Helen, Achten, Juul and Costa, Matthew L. (2012) The safety of peri-articular local anaesthetic injection for patients undergoing total knee replacement with autologous blood transfusion. The Journal of Bone and Joint Surgery (American), 94 (12). pp. 1632-1636. doi:10.1302/0301-620X.94B12.29357
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Official URL: http://dx.doi.org/10.1302/0301-620X.94B12.29357
Abstract
Intra-operative, peri-articular injection of local anaesthesia is an increasingly popular way of controlling pain following total knee replacement. At the same time, the problems associated with allogenic blood transfusion have led to interest in alternative methods for managing blood loss after total knee replacement, including the use of auto-transfusion of fluid from the patient's surgical drain. It is safe to combine peri-articular infiltration with auto-transfusion from the drain. We performed a randomised clinical trial to compare the concentration of local anaesthetic in the blood and in the fluid collected in the knee drain in patients having either a peri-articular injection or a femoral nerve block. Clinically relevant concentrations of local anaesthetic were found in the fluid from the drains of patients having peri-articular injections (4.92 μg/ml (sd 3.151)). However, none of the patients having femoral nerve blockade had detectable levels. None of the patients in either group had clinically relevant concentrations of local anaesthetic in their blood after re-transfusion. The evidence from this study suggests that it is safe to use peri-articular injection in combination with auto-transfusion of blood from peri-articular drains during knee replacement surgery.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RM Therapeutics. Pharmacology | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Blood -- Transfusion, Autologous, Total knee replacement | ||||||||
| Journal or Publication Title: | The Journal of Bone and Joint Surgery (American) | ||||||||
| Publisher: | STRIATUS Orthopaedic Communications | ||||||||
| ISSN: | 0021-9355 | ||||||||
| Official Date: | December 2012 | ||||||||
| Dates: |
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| Volume: | 94 | ||||||||
| Number: | 12 | ||||||||
| Number of Pages: | 5 | ||||||||
| Page Range: | pp. 1632-1636 | ||||||||
| DOI: | 10.1302/0301-620X.94B12.29357 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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