Does Extended-Release Liposomal Bupivacaine Better Control Pain Than Bupivacaine After Total Knee Arthroplasty (TKA)? A Prospective, Randomized Clinical Trial

被引：100

作者：

Schroer, William C. ^{[1
]}

Diesfeld, Paul G. ^{[1
]}

LeMarr, Angela R. ^{[1
]}

Morton, Diane J. ^{[1
]}

Reedy, Mary E. ^{[1
]}

机构：

[1] St Louis Joint Replacement Inst, St Louis, MO USA

来源：

JOURNAL OF ARTHROPLASTY | 2015年 / 30卷 / 09期

关键词：

bupivacaine; multimodal; pain management; total knee arthroplasty; periarticular injection; MULTIMODAL DRUG INJECTION; CONFLICT-OF-INTEREST; DOUBLE-BLIND; PERIARTICULAR INJECTION; POSTSURGICAL ANALGESIA; NERVE BLOCK; TOTAL HIP; MANAGEMENT; HEMORRHOIDECTOMY; INFILTRATION;

D O I：

10.1016/j.arth.2015.01.059

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Liposomal bupivacaine periarticular injection (PAI) offers sustained bupivacaine release after TKA, but few prospective independent studies exist. In this prospective, blinded study, liposomal bupivacaine was randomized against bupivacaine and incorporated into a comprehensive multimodal pain management protocol. 111 primary TKAs were randomized to receive PAI: 58 patients received 266 mg (20 cc) liposomal bupivacaine mixed with 75 mg (30 cc) 0.25% bupivacaine, and 53 patients received 150 mg (60 cc) 0.25% bupivacaine. Visual analog pain scores and narcotic use were determined. No pain score differences occurred between study and control patients: Day 1: 4.5/4.6 (P=0.73); Day 2: 4.4/4.8 (P=0.27); or Day 3: 3.5/3.7 (P=0.58). Narcotic use was similar during hospitalization, 51.8/54.2 (P=0.34). The study medication costs $285, and the control medication costs $2.80. This finding does not justify the routine use of liposomal bupivacaine. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：64 / 67

页数：4

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