Summary

The use of lidocaine patches as adjunctive therapy has an increasingly important role on analgesic control after total knee arthroplasty, combined with the basic regimen of analgesia for pain relief during the postoperative period.

Abstract

Introduction

The effective analgesic therapy in the postoperative period of total knee arthroplasty is essential for good surgical results. The use of lidocaine patches as adjunctive therapy has an increasingly important role on analgesic control after total knee arthroplasty. Objective: To investigate the potential benefits of lidocaine patches association to the basic regimen of analgesia for pain relief during the postoperative period of total knee arthroplasty. Methods: We performed a randomized controlled clinical trial, whose population submitted to total knee arthroplasty, which was extracted a sample of 48 patients: 24 allocated in the test group, receiving standard therapy of the hospital (opioids and analgesics) and lidocaine patches, and 24 in the control group, which used only the standard therapy. Patients were followed for a period of 28 days during which period there was five reviews 5: 24 hours 48 hours 72 hours, 14 days and 28 days after the surgery. The following variables were analyzed: pain intensity, required opioid analgesic doses for pain relief, quality of life of the patients, supported load and range of motion of the surgically addressed joint, complications during hospitalization, age, gender, index of body mass, affected side and comorbidities. Results: At all times analyzed postoperative pain was less intense in patients who received patches with lidocaine. In the same patients, the doses of opioids required to control pain were lower in 15 of the 28 analyzed days. The relative frequency of nausea was higher in the group that did not use adjuvant therapy. Predominated patients over 70 years and females. The most frequent comorbidity was overweight/obesity. Conclusion: The therapy after total knee arthroplasty using patches with lidocaine was effective in reducing pain and decreased use of opioids in the period analyzed, providing good increase to multimodal analgesic therapy.