High volume local infiltration analgesia (LIA) for total hip and knee arthroplasty: a brief review of the current status]

Local infiltration analgesia (LIA) is usually performed intraoperatively by the surgeon who injects 150 mL (300 mg Ropivacain, 30 mg Ketorolac and 0.5 mg adrenalin) into the bone, cartilage, ligament, musculature, or hyperdermis. A tight bandage and ice cooling for 4 - 6 hours lengthen the duration of analgesia, mobilisation can be undertaken about 5 hours after the operation. Besides large observation-in-use studies, there are 11 randomised studies in the fields of total hip and knee arthroplasty that report comparisons with systemic analgesia as well as with epidural or peripheral anaesthesia, all of which showed positive results for LIA. In addition LIA is safe, has favourable costs and does not require any special technical abilities in contrast to epidural and peripheral regional anaesthesia.