Background: Total Knee Arthroplasty is a common and successful surgery to relieve the pain in severe Osteoarthritis of knee. Post-operative pain after the surgery is an issue of concern as it influences the post operative recovery and rehabilitation. Several pain management strategies have been used in the past that include peripheral nerve blockade, patient‐controlled analgesia and local infiltration analgesia, and oral opioid/nonopioid medications. Our study aimed at studying the effect of intra operative administration of multimodal cocktail on post operative pain after total knee arthroplasty. Methods: Periarticular injection of the multimodal cocktail consisting of cefuroxime, bupivacaine, ketorolac, adrenaline and normal saline was injected intraoperatively to the right knee (study knee) and same volume (40 ml) normal saline was injected in left knee (Control Knee) of the same patient undergoing bilateral total knee replacement. The comparison of mean VAS Scores of the patients for both the knees at 6, 12, 24 48, 72 and 96 hours was noted. Mean time taken to do active straight leg raise(ASLR) and active 90 ̊ flexion was also compared for both the knees. Results: Statistically significant decrease in pain score was observed in right knee (cocktail injected) as compared to the left knee (normal saline injected) during 6, 12, 24, 48 and 72 hours (p value < 0.05). Mean time taken to do active straight leg raise (ASLR) and to do active knee flexion to 90 ̊ of right (study) knee after surgery was significantly less as compared to the left (control) knee. Conclusion: The present observational study showed that intra-operative injection of multimodal cocktail significantly reduces post-operative pain in patients of total knee arthroplasty and promoted early recovery and rehabilitation.
Keywords: Total knee Arthroplasty, multimodal cocktail, pain, VAS Score, recovery, range of motion.