Local infiltration analgesia with bupivacaine and adrenaline does not reduce perioperative blood loss in total hip arthroplasty

PLoS One. 2021 Sep 9;16(9):e0257202. doi: 10.1371/journal.pone.0257202. eCollection 2021.

Abstract

This study evaluates the effect of local infiltration analgesia with bupivacaine and adrenaline on perioperative blood loss in total hip arthroplasty. Patients who had primary total hip arthroplasty were retrospectively assigned to two groups. One group had 100 ml of bupivacaine/adrenaline solution injected into periarticular soft tissues at the end of the procedure. There were 55 patients in the infiltrated hip group and 44 patients in the not infiltrated group. Patients' hemoglobin level (Hb), hematocrit (HTC), red blood count (RBC), platelet count (PLT) and International Normalized Ratio (INR) as well as the need for blood transfusions were compared statistically between groups preoperatively and postoperatively. There were no significant differences between Hb, HTC or RBC levels as well as the rate and amount of blood transfusions on the 1st, 4th postoperative days or at patients' discharge between infiltrated and not infiltrated groups. This study does not support the hypothesis that the use of local infiltration analgesia with adrenaline may reduce perioperative blood loss in total hip arthroplasty.

MeSH terms

  • Aged
  • Analgesia / methods*
  • Anesthetics, Local
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods*
  • Blood Loss, Surgical
  • Body Mass Index
  • Bupivacaine / administration & dosage*
  • Epinephrine / administration & dosage*
  • Female
  • Hematocrit
  • Hemoglobins / analysis
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Pain Management / methods
  • Platelet Count
  • Poland
  • Preoperative Period
  • Retrospective Studies

Substances

  • Anesthetics, Local
  • Hemoglobins
  • Bupivacaine
  • Epinephrine

Grants and funding

The author(s) received no specific funding for this work.