Journal
JOURNAL OF ARTHROPLASTY
Volume 31, Issue 9, Pages S22-S25Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2016.03.036
Keywords
liposomal bupivacaine; multimodal pain control; total knee arthroplasty; postoperative pain management; periarticular injection; intra-articular injection
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Funding
- Virtua Joint Replacement Institute
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Background: Intraoperative injections can help reduce early postoperative pain in total knee arthroplasty. We proposed that liposomal bupivacaine would not be superior to more common and cheaper injections. Methods: A single-blinded prospective randomized study with 207 consecutive patients was completed. Patients were randomized to treatment with periarticular liposomal bupivacaine injection, periarticular injection of bupivacaine/morphine, or intra-articular injection of bupivacaine/morphine at the conclusion of the procedure. Postoperative visual analog pain scores and narcotic consumption were recorded and analyzed. Results: There was no significant difference in postoperative visual analog pain scores or narcotic consumption among the 3 study groups. Conclusion: Intra-articular injection of bupivacaine and morphine is as effective for postoperative pain control in total knee arthroplasty as periarticular bupivacaine/morphine injection and liposomal bupivacaine. Use of liposomal bupivacaine in total knee arthroplasty is costly and not justified. (C) 2016 Elsevier Inc. All rights reserved.
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