Jeffrey H DeClaire1, Paige M Aiello2, Olayinka K Warritay3, Dwight C Freeman4. 1. Department of Surgery and Orthopaedic Surgery, DeClaire LaMacchia Orthopaedic Institute, Crittenton Hospital Medical Center, Rochester Hills, Michigan. 2. Wayne State University School of Medicine, Detroit, Michigan. 3. Department of Family Medicine and Public Health Services, Wayne State University School of Medicine Family Medicine Residency Program at Crittenton Hospital, Rochester Hills, Michigan. 4. Department of Biological Sciences, Wayne State University, Detroit, Michigan.
Abstract
BACKGROUND: We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control. METHODS: This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection ofropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, visual analog pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded. RESULTS: There was no significant difference between the two groups (control N = 49, experiment N = 47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or visual analog score for pain postoperatively. CONCLUSION: There is no benefit in the use of liposomal bupivacaine compared with ropivacaine for postoperative pain control in TKA.
RCT Entities:
BACKGROUND: We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control. METHODS: This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, visual analog pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded. RESULTS: There was no significant difference between the two groups (control N = 49, experiment N = 47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or visual analog score for pain postoperatively. CONCLUSION: There is no benefit in the use of liposomal bupivacaine compared with ropivacaine for postoperative pain control in TKA.
Authors: Jason P Zlotnicki; Brian R Hamlin; Anton Y Plakseychuk; Timothy J Levison; Scott D Rothenberger; Kenneth L Urish Journal: J Arthroplasty Date: 2018-03-16 Impact factor: 4.757