Intraoperative IV Cocktails

Intraoperative Cocktails for Pain Control

Pain management or control is mainly focused on alleviating your pain and enabling you to carry out day to day activities. Pain control following surgery such as total knee replacement is essential in post-operative rehabilitation. The use of parenteral opioids or epidural analgesia can cause unwanted side effects hindering early rehabilitation and recovery.  Infiltration of an analgesic cocktail locally can help avoid these side effects. In studies done, the knee that received the intraoperative cocktail had significantly less post-operative pain and a shorter time period to attain 90° of knee flexion.

What are Intraoperative Cocktail Injections?

Intraoperative cocktail injections are usually a mixture of non-steroidal anti-inflammatory drugs, long-acting anesthetic, and epinephrine as a base. In addition, corticosteroids may be added. However, studies show that there is no difference in the cocktail with the addition of various dosages of corticosteroids or a conventional cocktail without corticosteroids.

How is Intraoperative Cocktail Injections Administered?

Intraoperative cocktail injections may be performed using various approaches. During the procedure, you will be seated or will lie on your back with the affected knee or hip joint flexed or extended. The skin over the injection site is sterilized and numbed with a local anesthetic. 

The needle is inserted into your joint and the medication is injected.  In some cases, ultrasound imaging is used to help guide the needle to the correct site. You may feel some mild discomfort during the injection. A small dressing is then applied over the injection site to complete the procedure.

What are the Indications for Intraoperative Cocktail Injections?

Intraoperative cocktail injections are indicated to alleviate postoperative pain in joint replacement surgery.

What are the Advantages of Intraoperative Cocktail Injections?

The periarticular cocktail analgesic injection has several advantages over traditional methods such as epidural analgesic, and peripheral nerve block. The method is reproducible, reliable, technically less demanding, and provides better pain control in the postoperative period and also aids in early recovery and rehabilitation. Other advantages include:

  • Improved range of motion
  • Improved patient satisfaction rate
  • Reduced analgesic requirements
  • Minimized the length of hospital stay

Other Hand & Arm Procedures

  • American Academy of Orthopaedic Surgeons - AAOS
  • Mississippi State Medical Association
  • Ruth Jackson Orthopaedic Society
  • American Society for Surgery of the Hand