Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Nov 18;19(1):764.
doi: 10.1186/s13018-024-05233-6.

Magnesium sulphate and sodium bicarbonate as additives for periarticular local infiltration analgesia improve pain management after unicompartmental knee arthroplasty: a prospective, double-blind, randomized controlled trial

Yuchen Zhu #  1 , Shaoning Shen #  1 , Longkang Cui  1 , Lianguo Wu  2 , Bingbing Zhang  3
Affiliations
Randomized Controlled Trial

Magnesium sulphate and sodium bicarbonate as additives for periarticular local infiltration analgesia improve pain management after unicompartmental knee arthroplasty: a prospective, double-blind, randomized controlled trial

Yuchen Zhu et al. J Orthop Surg Res. .

Abstract

Background: Periarticular local infiltration analgesia (LIA) has become a widely used method for postoperative pain management after unicompartmental knee arthroplasty (UKA). However, the efficacy of using magnesium sulphate or sodium bicarbonate in LIA cocktails during UKA is not yet clear. The present study aimed to evaluate whether the modified LIA has advantages in pain control and joint function recovery after UKA surgery.

Methods: Sixty-one patients who underwent UKA were enrolled and randomly assigned to receive periarticular infiltration of a modified cocktail (comprising ropivacaine, epinephrine, dexamethasone, magnesium sulphate, and sodium bicarbonate) or a conventional cocktail (comprising ropivacaine, epinephrine, dexamethasone, ketorolac, and morphine). The outcomes included the consumption of patient-controlled intravenous analgesia (PCIA) medication used for postoperative analgesia, pain score, early joint functional recovery, discharge time, and complication rates.

Results: In the first 12 h after surgery, the conventional cocktail was not superior to the modified cocktail in terms of visual analogue scale (VAS) scores. However, beginning on the second postoperative day, the analgesic effect was significantly prolonged in the modified group, leading to lower VAS scores and better knee functional recovery. Additionally, patients in the modified group required less pain medication via PCIA, both within the first 24 h and cumulatively up to 48 h after surgery. Both groups had similar rates of complications.

Conclusions: The present modification of a conventional cocktail significantly prolonged the analgesic effect and reduced pain medication consumption after UKA surgery, which was associated with better functional recovery in the early postoperative days.

Trial registration: Chinese Clinical Trial Registry, ChiCTR2200060500. 21 March 2023.

Keywords: Analgesic drugs; Cocktail; Magnesium sulphate; Periarticular local infiltration analgesia; Sodium bicarbonate; Unicompartmental knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

Declarations Ethics approval and consent to participate Ethics approval was obtained from the ethics committee of our hospital and informed consent was provided by all participants. Approval number: 008-IH01. The study was registered in the Chinese Clinical Trials Registry with the registration number: ChiCTR2200060500. 21 March 2023. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Periarticular local cocktail injection
Fig. 2
Fig. 2
Flow diagram of the patient selection
Fig. 3
Fig. 3
Postoperative VAS pain scores at rest (Fig. 3A) and during motion (Fig. 3B) in both groups. * Indicates a significant difference (p < 0.05) between the two groups
Fig. 4
Fig. 4
Appearance of the cocktail groups
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Migliorini F, Driessen A, Oliva F, Maffulli GD, Tingart M, Maffulli N. Better outcomes and reduced failures for arthroplasty over osteotomy for advanced compartmental knee osteoarthritis in patients older than 50 years [J]. J Orthop Surg Res. 2020;15(1):545. - PMC - PubMed
    1. Hurst JM, Ranieri R, Berend KR, Morris MJ, Adams JB, Lombardi AV. Jr. Outcomes after arthroscopic evaluation of patients with painful medial unicompartmental knee arthroplasty [J]. J Arthroplasty. 2018;33(10):3268–72. - PubMed
    1. Bianconi M, Ferraro L, Traina GC, Zanoli G, Massari L. Pharmacokinetics and efficacy of ropivacaine continuous wound instillation after joint replacement surgery [J]. BJA Br J Anaesth. 2004;91(6):830–5. - PubMed
    1. Nakai T, Tamaki M, Nakamura T, Nakai T, Onishi A, Hashimoto K. Controlling pain after total knee arthroplasty using a multimodal protocol with local periarticular injections [J]. J Orthop. 2013;10(2):92–4. - PMC - PubMed
    1. Wang Q, Tan G, Mohammed A, Zhang Y, Li D, Chen L, Kang P. Adding corticosteroids to periarticular infiltration analgesia improves the short-term analgesic effects after total knee arthroplasty: a prospective, double-blind, randomized controlled trial [J]. Knee Surg Sports Traumatol Arthrosc. 2021;29(3):867–75. - PubMed

Publication types

MeSH terms

LinkOut - more resources