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#35862 Periarticular vasoconstrictor infiltration ultrasound-guided technique for total knee arthroplasty. A case series
  1. Maria Paz Sebastian1 and
  2. Vicente Roques2
  1. 1Anaesthetics, Royal National Orthopaedic Hospital, Stanmore, UK
  2. 2Anaesthetics, Virgen the Arrixaca, Murcia, Spain


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Background and Aims Total knee arthroplasty accompanied by significant blood loss and severe postoperative pain. We present a novel technique called Periarticular Vasoconstrictor Infiltration, which involves an ultrasound-guided high-volume injection of a mixture of local anaesthetic and epinephrine around the knee joint aiming to provide effective postoperatively analgesia and intraoperative haemostasis without the need of a tourniquet while maintaining hemodynamic stability.

Methods This is retrospective observational study. Our main outcomes were intraoperative estimated blood loss and opioid consumption during the first 24h after surgery in patients who underwent TKA without a tourniquet using Periarticular Vasoconstrictor Infiltration technique in our hospital between November 2022 and February 2023. Patients who were chronic opioid users from our search were excluded.

Results Five patients met the inclusion criteria during the time frame, with a mean age of 72 years old (67-83). Intraoperative EBL was less than 100ml in all the five patients. None of the five patients required rescue opioids during the first 12h after surgery. The mean time for the first opioid request, was 17 hours (15-19) and the mean 24-hour dose of oral morphine equivalent was 20mg (10-20). All patients mobilize within 24h after surgery.

Abstract #35862 Figure 1

Injection points in PVI and sonography of different approaches

Conclusions Periarticular Vasoconstrictor Infiltration technique minimizes intraoperative blood loss during TKA, provides effective pain relief and allows early mobilization. Further studies are needed to validate the efficacy of Periarticular Vasoconstrictor Infiltration against alternatively techniques.

  • Total Knee Arthroplasty
  • Genicular block
  • Pain

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