Is There a Benefit for Liposomal Bupivacaine Compared to a Traditional Periarticular Injection in Total Knee Arthroplasty Patients With a History of Chronic Opioid Use?

The Journal of Arthroplasty
Ran SchwarzkopfJoseph B Rinehart

Abstract

Postoperative pain after total knee arthroplasty (TKA) poses a major challenge. It delays mobilization, increases opioid consumption and side effects, and lengthens hospitalization. This challenge multiplies when treating an opioid-dependent population. We examined whether a novel suspended release local anesthetic, liposomal bupivacaine (LB) would improve pain control and decrease opioid consumption after TKA compared to a standard periarticular injection in opioid-dependent patients. Thirty-eight patients undergoing TKA were randomly assigned to receive either a periarticular injection (PAI) with LB (n = 20) or with a standard PAI (including a combination of ropivacaine, clonidine, Toradol, Epinepherine, and saline; n = 18) as part of a multimodal pain management approach. All periarticular injections were done by a single surgeon. Perioperative treatment was similar between groups. Postoperative information regarding pain level was evaluated by a pain visual analog scale score. Postoperative opioid consumption was recorded. After controlling baseline narcotic usage before surgery, no differences were found between groups in daily postoperative narcotic usage (P = .113), average daily pain score (P = .332), or maximum daily p...Continue Reading

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References

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Citations

Jul 23, 2016·Journal of Orthopaedic Surgery and Research·Zhong Qing WuHeng Li
May 26, 2017·Knee Surgery & Related Research·Yong Seuk Lee
Mar 13, 2018·Clinical Orthopaedics and Related Research·Stephen YuRichard Iorio
Aug 9, 2017·Foot & Ankle International·Ryan P MulliganSelene G Parekh
Jul 23, 2016·Clinical Orthopaedics and Related Research·Philippe Richebé, Véronique Brulotte
Nov 10, 2020·The Journal of Knee Surgery·Tal Frenkel RutenbergSnir Heller
Apr 4, 2021·Healthcare·Sara J HylandRobert K Cleary
May 16, 2021·Archives of Orthopaedic and Trauma Surgery·David N KugelmanWilliam J Long
Sep 10, 2021·The Annals of Pharmacotherapy·Atul DilawriSneha Shah

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