Yoeri Bemelmans

Chapter 4 54 consensus on the widespread used analgesia. This study found limited evi-dence to support the role of adrenaline during intra-oper-ative single-shot LIA in combination with ropivacaine in patients undergoing TKA. Further larger RCT’s exploring the effect of adrenaline are of interest [10, 17, 27, 28, 30, 33]. Finally, we recommend that LIAwith only ropivacaine should be part of daily practice in TKA including a well-establishedmultimodal pain protocol to cope with postop-erative pain, without the possible negative side effects of adrenaline. Conclusion This randomized, double-blind, prospective clinical trial could not confirm the added value of adrenaline into the ropivacaine solution for LIA, since both groups showed comparable experienced pain during the first 48 h postoperative. Acknowledgments The authors are thankful for all the efforts from the health care staff including anesthesiologists, OR assistants, nurses, physical therapists, managers andward doctors working at the Orthopedic department of OrbisMedical Center. One of the authors (NK) is a paid consultant for Biomet and lectures on the patient-spe-cificmatched instruments for total knee arthroplasty. Authors’ contribution MS, HK, JJ and NK designed the study. HK did the randomization. MS collected the data. MS and YB analysed and interpreted the data. MS and YB wrote the manuscript, HK, JJ and NK revised it.