Anästhesiol Intensivmed Notfallmed Schmerzther 2011; 46(2): 84-86
DOI: 10.1055/s-0031-1272875
Fachwissen
Anästhesiologie
© Georg Thieme Verlag Stuttgart · New York

Lokale Infiltrationsanästhesie (LIA) für Hüft- und Kniegelenksendoprothesen – Eine kurze Übersicht über den aktuellen Stand

High volume local infiltration analgesia (LIA) for total hip and knee arthroplasty: a brief review of the current statusAstrid M. Morin, Hinnerk Wulf
Further Information

Publication History

Publication Date:
10 February 2011 (online)

Zusammenfassung

Die lokale Infiltrationsanästhesie (LIA) erfolgt intraoperativ durch den Chirurgen, der 150ml (300mg Ropivacain, 30mg Ketorolac und 0,5 mg Adrenalin) in Knochen, Knorpel, Bänder, Muskulatur, Subkutis injiziert. Ein strammer Verband und eine Eiskühlung für 4–6h verlängern die Analgesiedauer, ± 5h nach der Operation wird mobilisiert. Neben großen Anwendungsbeobachtungen existieren 11 randomisierte Studien in der Hüft- und Knieendoprothetik im Vergleich zur systemischen Analgesie, Epidural- oder peripheren Regionalanästhesie, allesamt mit positivem Ergebnis für die LIA. Zudem ist die LIA sicher, preisgünstig und erfordert keine besonderen technischen Fertigkeiten im Vergleich zur Epidural- und peripheren Regionalanästhesie.

Abstract

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.

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PD Dr. med. Astrid Morin
Prof. Dr. med. Hinnerk Wulf

Email: morin@staff.uni-marburg.de

Email: h.wulf@med.uni-marburg.de