Liposomal Bupivacaine Injection Technique in Total Knee Arthroplasty
| Autor: | Luke R. Lovro, Philip H. Ireland, R. Meneghini, Deren Bagsby, Mary Ziemba-Davis |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Epinephrine Total knee arthroplasty Injections Intra-Articular 03 medical and health sciences 0302 clinical medicine Pain control medicine Humans Ropivacaine Orthopedics and Sports Medicine 030212 general & internal medicine Anesthetics Local Arthroplasty Replacement Knee Aged Pain Measurement Retrospective Studies Pain Postoperative 030222 orthopedics business.industry Retrospective cohort study Middle Aged Liposomal Bupivacaine Amides Bupivacaine Surgery Analgesics Opioid Treatment Outcome Opioid Anesthesia Liposomes Morphine Female business medicine.drug |
| Zdroj: | The Journal of Knee Surgery. 30:88-96 |
| ISSN: | 1938-2480 1538-8506 |
| DOI: | 10.1055/s-0036-1581133 |
| Popis: | Liposomal bupivacaine has gained popularity for pain control after total knee arthroplasty (TKA), yet its true efficacy remains unproven. We compared the efficacy of two different periarticular injection (PAI) techniques for liposomal bupivacaine with a conventional PAI control group. This retrospective cohort study compared consecutive patients undergoing TKA with a manufacturer-recommended, optimized injection technique for liposomal bupivacaine, a traditional injection technique for liposomal bupivacaine, and a conventional PAI of ropivacaine, morphine, and epinephrine. The optimized technique utilized a smaller gauge needle and more injection sites. Self-reported pain scores, rescue opioids, and side effects were compared. There were 41 patients in the liposomal bupivacaine optimized injection group, 60 in the liposomal bupivacaine traditional injection group, and 184 in the conventional PAI control group. PAI liposomal bupivacaine delivered via manufacturer-recommended technique offered no benefit over PAI ropivacaine, morphine, and epinephrine. Mean pain scores and the proportions reporting no or mild pain, time to first opioid, and amount of opioids consumed were not better with PAI liposomal bupivacaine compared with PAI ropivacaine, morphine, and epinephrine. The use of the manufacturer-recommended technique for PAI of liposomal bupivacaine does not offer benefit over a conventional, less expensive PAI during TKA. |
| Databáze: | OpenAIRE |
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