The ALOHA trial: (intra-articular local anaesthetic in hip arthroscopy)—a three-arm randomized trial comparing pre-emptive, high- and low-dose intra-articular local anaesthetic in hip arthroscopy

Abstract

Abstract Pain after hip arthroscopy is variable and can be severe despite multimodal analgesia. Intra-articular local anaesthetic (IALA) may reduce acute postoperative pain after hip arthroscopy. However, neither its optimum dose nor timing of administration have been systematically evaluated. In 132 patients, a double-blinded, three-arm randomized controlled trial comparing IALA used during hip arthroscopy was conducted comparing 100 mg ropivacaine given at the end of the procedure (Group L, lose dose), 200 mg ropivacaine at the end of the procedure (Group H, high dose) and 100 mg of ropivacaine given at the beginning and end of the procedure (Group P, pre-emptive). There were no statistically significant differences between the three groups for Numerical Rating Scale-11 pain scores in the recovery room [mean (standard deviation): Group L—2.2 (1.9); Group H—2.3 (2.1); Group P—2.7 (2.5); lowest P = 0.6], or post-recovery room Visual Analogue Scale pain scores at 2, 4 and 6 h. There were also no significant differences in antiemetic usage and requirement for rescue fascia iliaca blockade between the three groups. Compared to a single 100 mg dose of ropivacaine at the end of the procedure, we were unable to demonstrate any advantage of either a higher dose IALA or a pre-emptive dose IALA when multimodal analgesia is used.