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Application for ESRA Abstract Prizes : I apply as an Anesthesiologist (Aged 35 years old or less)Background and Aims Total knee arthroplasty (TKA) is a frequent procedure that requires effective management of postoperative pain and bleeding. The technique of modified periarticular infiltration (PVI) with vasoconstrictors can be a strategy to improve analgesia, reduce the use of opioids and control bleeding thanks to the chemical tourniquet.Methods We present 10 cases undergoing TKA, ASA 2–3. Spinal anesthesia with isobaric bupivacaine was followed by ultrasound-guided modified PVI ( figure 1), under strict aseptic conditions, using 100 mL of ropivacaine 0,2% with 1:200,000 adrenaline, and intraoperative propofol sedation.Results The time to perform the technique was 20±5,6 minutes and after 30±8,5 minutes the surgical incision could be made. Tourniquet was not used. Tranexamic acid, antibiotics and 24 mg of dexamethasone were administered per protocol. Intraoperative blood loss was under 300 mL. Patients had an average VAS of 3 ± 1.5 at 24 hours. 8 patients required a tramadol dose for pain during the first 24 hours, 6 only 1 dose. Postoperative hemoglobin was 10,75±1,11 g/dL with no cases of severe anemia. Neither of the patients required blood transfusion. All ambulated within 5 to 18 hours and 9 patients were discharged on postoperative day two without complications. No adverse events related to the technique were reported. Surgeon satisfaction was very good in 8 cases and good in 2 because the field was not completely drained of blood.Abstract P082 Figure 1Description of modified PVIConclusions PVI modified for TKA provides effective pain control, reduces perioperative bleeding, and promotes faster recovery. The technique can affect both the time taken to complete the operation and surgeon satisfaction. The technique has proven to be safe and effective, although results are promising, larger studies are needed to confirm its long-term