Efficacy of Multimodal Analgesic Injections in Operatively Treated Ankle Fractures

• DOI: 10.2106/jbjs.19.00293
• Publication Date: 2019-10-09T18:31:42Z
• Authors: Kyle John Hancock; Olivia M. Rice; Chris A. Anthony; Natalie Glass; Matthew Hogue; Matthew Karam; J. Lawrence Marsh; Michael C. Willey
• Keywords: Ropivacaine

Background: Pain management following surgical treatment of an ankle fracture is under-studied area clinical practice. The present study evaluated the efficacy a multimodal surgical-site injection as adjunct to postoperative pain in patients with operatively treated, closed, rotational fracture. Methods: Patients indicated for operative fixation were randomized receive (ropivacaine 200 mg, epinephrine 0.6 and morphine 5 mg) or no (control). Visual analog scale (VAS) opioid consumption data collected every 4 hours until discharge from hospital. Length stay destination recorded. sent automated text messages report VAS usage during first 2 weeks after discharge. Results: One hundred (49 51 control) enrolled. Demographic similar between groups. Mean scores over 24 48 postoperatively slightly lower group (42 ± 3 41 3, respectively) compared control (52 50 respectively; p = 0.01 < 0.01, respectively). median usage, terms equivalent dose, was (25.5; range, 0 74.7) (28.3; 2.5 91.0; 0.35). recovery room admission also (29.0; 85.3) (32.7; 4.3 215.0; There differences outpatient assessed use messaging. Median length 22.3 (range, 1.7 182.3 hours) 22.5 2.2 123.3 (p 0.71). response rate post-discharge 85.1%. Complication rates similar. Conclusions: injections treated fractures associated reduction immediate in-hospital that statistically significant but below minimal clinically important difference. Level Evidence: Therapeutic I . See Instructions Authors complete description levels evidence.