Background and purpose. Local infiltration analgesia (LIA) supports early mobilization after hip and knee arthroplasty. Inspired by\nthis, we studied the effectiveness of wound infiltration with the long acting local anesthetic ropivacaine in an effort to decrease the\nneed for postoperative opioids after osteosynthesis of extracapsular hip fracture. Methods. Forty-nine patients undergoing\nosteosynthesis with a sliding hip screw were randomized into two groups in a double-blind study (ClinicalTrials.gov:\nNCT01119209). The patients received intraoperative infiltration followed by 6 postoperative injections through a wound catheter\nin eight-hour intervals. 23 patients received ropivacaine and 26 received saline. The intervention period was 2 days, and the\nobservation period was 5 days. In both groups, there were no restrictions on the total daily dose of opioids. Pain was assessed at\nspecific postoperative time points, and the daily opioid usage was registered. Results. Intraoperative infiltration with 200 mg\nropivacaine and postoperative repeated infiltration with 100 mg ropivacaine did not result in statistically significant difference\nbetween the groups regarding postoperative opioid consumption or pain. Interpretation. Ropivacaine as single component in\npostoperative treatment of pain after hip fracture is not effective. In our setup, wound infiltration with ropivacaine is not\nstatistically significantly better than placebo.
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