Comparative Efficacy of Periarticular Fentanyl versus Ketorolac for Postoperative Pain in Total Hip Arthroplasty: A Randomized Controlled Trial.

研究概要

Ninety patients undergoing elective primary total hip arthroplasty (THA) were randomized to receive bupivacaine+fentanyl Local infiltration analgesia (LIA) (n=30), bupivacaine+ketorolac LIA (n=30), or normal saline placebo (n=30). The primary outcome was pain (VAS) at 6, 12, 24, and 48 hours. Secondary outcomes included cumulative postoperative diclofenac consumption, time to ambulation, length of stay, and postoperative nausea/vomiting. Outcomes were assessed up to 48 hours (for pain/complications) and through discharge (for recovery metrics). Overall, the results revealed consistently lower VAS scores with bupivacaine+fentanyl versus ketorolac and placebo, with concordant reductions in rescue analgesic use, earlier ambulation, shorter hospitalization, and fewer nausea/vomiting events. These findings suggest fentanyl-based periarticular LIA provides superior early analgesia and recovery advantages after THA.