The main purpose of this study is to determine if there is improvement in pain and other patient outcomes when using a continuous wound analgesia system after total knee replacement, compared to usual methods of pain control. Another purpose is to determine if the system makes it easier for nurses to care for these patients.
Continuous local wound infusion analgesia is a relatively new way of managing post-operative pain, whereby a local anesthetic is continuously infused into the surgical area. Some studies and users have reported decreased pain, decreased opioid use, decreased post-operative nausea and vomiting, decreased length of stay, and improved patient and caregiver satisfaction with the use of continuous local wound infusion analgesia, when compared to placebo, or usual care, in arthroplasty and other surgical interventions. Hypotheses: Primary: The On-Q PainBuster (continuous wound infusion analgesia) in TKA will result in improved patient pain control, compared to usual care. Secondary: * Pain scores post-operatively will be better than usual care. * Fewer narcotics will be ingested post-operatively than with usual care. * Post-op nausea and vomiting will be less than usual care. * Length of stay will be shorter compared to usual care. * Patient satisfaction will be greater than satisfaction with usual care. * Post-operative infection rates will be no different between groups. * Fall rates will be no different between groups. * Subjects will participate in physical therapy the day of surgery. * Nursing Intensity requirements will be less with the wound infusion due to fewer requests for pain medication.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
On-Q PainBuster continuous wound infusion analgesia system, using bupivacaine as the local anaesthetic
Usual Care
Royal Alexandra Hospital
Edmonton, Alberta, Canada
Pain, measured by the 11-point numerical pain rating scale
Time frame: Post-operatively for three days then again at follow-up
Post-operative nausea and vomiting
Time frame: Post-operatively for three days
Narcotic medications taken
Time frame: Post-operatively for three days
Time to first mobilization, first transfer and first 30-M walk
Time frame: Up to three days post-operatively
Number of adverse events
Time frame: Three days post-op (observed) then at follow-up (self-report)
Length of Stay
Time frame: Time of surgery to discharge
Satisfaction (patient and caregiver)
Time frame: Discharge from hospital
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