REGIONAL ANAESTHESIA High-volume local infiltration analgesia combined with intravenous or local ketorolac1morphine compared with epidural analgesia after total knee arthroplasty

Key points † After total knee arthroplasty, local infiltration analgesia (LIA) with intra-articular ketorolac and morphine was superior to epidural anaesthesia after the initial 24 h. † Epidural anaesthesia offered better initial pain relief, despite more common side-effects such as hypotension at the post-anaesthetic care unit. † Ketorolac and morphine showed a superior therapeutic balance when given as intra-articalur adjuvants than when given i.v. † Patients getting LIA had superior knee function, were mobilized faster, and were discharged earlier from hospital. Background. Recently, high-volume local infiltration analgesia (LIA) in total knee arthroplasty (TKA) has been introduced, but dosage, timing, and effects of adjuvants are still debated.