Local Anaesthetic Infiltration versus Open Approach for Length of Hospital Stay in Adults with Exercise Therapy: A Randomized Controlled Trial

Abstract

Background: Musculoskeletal disorders often require interventions that influence postoperative recovery and hospital resource utilization. Evidence comparing local anaesthetic infiltration with an open approach remains limited.

Objective: To compare hospital length of stay, postoperative pain, functional recovery, complications, adverse events, and readmission between the two approaches.

Methods: This prospective, parallel-group randomized controlled trial was conducted at a tertiary care hospital at Sargodha from January to December 2025. A total of 150 male patients aged 18–64 years were randomized equally to local anesthetic infiltration or an open approach. Both groups received standardized exercise therapy. The primary outcome was hospital length of stay. Secondary outcomes included pain at 24, 48, and 72 hours, functional recovery, complications, adverse events, and 30-day readmission. Analyses followed the intention-to-treat principle.

Results: Mean hospital stay was 4.2 ± 1.8 days with infiltration and 5.7 ± 2.3 days with the open approach. The adjusted mean difference was −1.4 days (95% confidence interval [CI], −2.1 to −0.7; p < 0.001). Pain scores were lower with infiltration at 24 hours (mean difference, −0.8; 95% CI, −1.3 to −0.3; p = 0.002), 48 hours (−0.8; 95% CI, −1.2 to −0.4; p < 0.001), and 72 hours (−0.6; 95% CI, −1.0 to −0.2; p = 0.003). Functional scores were higher at discharge (mean difference, 4.2; 95% CI, 0.1–8.3; p = 0.045), but not at six weeks. Complications and readmissions did not differ significantly

Conclusion: Local anaesthetic infiltration was associated with shorter hospitalization, reduced early pain, and improved discharge function. Multicentre trials are needed to confirm generalizability and comparative safety.